What is a normal pouch?
The gastrointestinal tract is made of smooth muscle which streches and constricts to pass food along the tract and to accommodate different sizes and consistencies of food. The lapband is surgically places a the gastroesophageal junction where the esophagus wides and becomes the upper part of the stomach. When the band is tighteded, it narrows this area creating an hour glass appearance and a small pouch of stomach above the band. It is the small pouch that aids in your weight loss by limiting the amount of food you can eat at one time. Once it is stretched, you will feel a fullness or slight pressure in your chest area. This is a signal to stop eating. (Some people also experience hiccuping, runny nose, and other things.)
What happens when a pouch is dilated?
The pouch can be overstretched by overating, eating too fast, taking bites that are too big, eating foods that are uncomfortable, vomiting, or having your band too tight. If you continually overstretch your pouch, you can cause your pouch to dilate or "stretch out" and then it will hold more food. You may notice weight gain or that you can eat larger portions of food. If you continue eating the larger portions, it worses the problem by further stretching the pouch.
What is a slip?
Slippage occurs when the stomach below the band 'slips' up through the stoma (the opening inside the band between the pouch and the rest of the stomach), causing a prolapsed or herniated pouch. This herniated area can hang over the edge of the band causing food to be stuck in the pouch and preventing it from passing through the stoma to the larger stomach. This is what causes heartburn, regurgitation, vomiting and pain that can be associated with a symptomatic slip. In severe 'slippage' circulations to the stomach can be compromised requiring a second surgery to repair the slippage or to remove the band if there is too much scar tissue to repair the area. It is believed that vomiting is the biggest cause of a slip, so go to the doc if you are experiencing ongoing vomiting.
What should I do if I think I have a dilation or slip?
Although these complications are not common (I think they are more common than they are reported, but that is my opinion and not in any way based on fact.) they can be serious. Summarizing now...Follow the rules. If you think there is a problem, go get it checked out. Don't wait.
What will happen if I am diagnosed with a dilation or slip?
For most dilations or slips the first non-surgical step to treat the problem is to remove all fluid from the band to allow the system to rest. This will relieve some of the stress on the pouch which has led to dilation and hopefully allow the pouch to regain some of its tone so that it can again function to limit portions. (Translation - back to liquids.) In a slip, removing the fluid enlarges the stoma, increasing the chances that the stomach which slipped above the band can slip back down.