Abdominal pain/vomiting in post-op period: Can indicate internal herniation – admit urgently.
Acute-onset dysphagia: Can indicate acute band slippage (sometimes severe enough to cause gastric ischaemia) and requires urgent referral for band deflation.
Reflux symptoms: Can indicate chronic band slippage and requires referral to the bariatric team.
Recurrent port-site infections and/or loss of restriction: Either of these can indicate band erosion (where the band slowly cuts through the stomach) and requires referral back to the bariatric team for advice.
Nutritional deficiencies: Patients should have their calcium, B12, and iron measured at 6-monthly intervals, or more often if clinically indicated.
Dumping syndrome: The good news is that this has a good prognosis – although most patients have this after surgery, by about 18 months down the line only about 5 – 10% will be left with chronic symptoms. Meanwhile, advise that they eat slowly and consume some carbohydrates mid-meal, which can dramatically improve symptoms.
Gallstones: Can occur in up to 30% following bariatric surgery (related to rapid weight loss) but are far more likely after bypass than banding.
(From Pulse 23.11.11)