A patient was referred to us for second opinion who was experiencing nausea, vomiting, GERD.  The patient had Duodenal Switch procedure many years ago but more recently had developed significant nausea, worsening reflux and solid intolerance. The patient had an endoscopy a few months ago and was only found to have a stricture within the Duodenum, no definitive treatment was offered at the time to the patient. On second examination of this patient with a second EGD the result was development of diffuse Duodenal ulcers  and stricture.

Note that these images are nearly identical positioning showing the stricture at 9 position. The image on the right also shows patchy ulcers.

Any changes in GERD, nausea, vomiting, gastric pain or discomfort after weight loss surgery should always be evaluated, treated, and followed. In a previous blog, the effects of GERD have been described.