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Productive Burping (PB’ing)

A common occurrence for banded patients is regurgitation of non-acidic swallowed food from the upper pouch, commonly known as PB’ing (Productive Burping). This is not to be considered normal. The patient should consider eating less, eating more slowly, or chewing their food more thoroughly. Occasionally, the narrow passage into the larger / lower part of the stomach may become blocked by a large portion of unchewed or unsuitable foodstuff.

A single episode of regurgitation can be caused by:

• To large of a bite
• Swallowing a second bite too soon
• Eating too fast
• Not chewing thoroughly
• Eating too much

When regurgitation is frequent or even a daily event:

• Your band may be too tight
• You may have a swollen stomach due to food dislodged or repetitive vomiting
• You may be frequently displaying the behaviors listed above

Reflux

Acid reflux is different than regurgitation. It is not food that just went down and is returning up. This actually is the acid produced in the stomach, which is burning the lower esophagus. Heartburn is the main symptom, which can be caused by a band that is too tight or swelling of the stomach lining. This condition requires immediate medical attention for treatment as it can evolve into a major complication.

No weight loss

The band is too loose:

• If you can eat more than a third of your pre-surgical intake of solid foods

Your band could be too tight:

• If you can only eat soft or liquid foods or if solid foods always get stuck
• You have the right fill level but you are not eating solid food
• You are consuming only high calorie foods

Slippage: 2-3%

When the upper pouch of the stomach pulls the lower stomach through the band. This pushes the band down on the stomach. As more stomach is pulled through the band and the band is displaced distally, the band surrounds more stomach until it totally obstructs. This causes varying degrees of intolerance to solids of liquids or even total obstruction, depending on the degree of slippage. All slips require surgical repositioning. This surgery is very straightforward and should not be postponed, recovery tends to be faster and re-slippage is rare.

Erosions: Less than 1%

Though erosions are very rare, (even rarer than slippages) they do sometimes occur. The Lap Band is an implant and it is subject to natural body reactions, including elimination. The inside of the stomach, for practical purposes is outside of the body. Since the Lap Band is considered a foreign body, the body may react to it trying to eliminate it into the stomach. All erosions require surgery for removal and replacement of the band if so decided by you and your doctor. Though not considered a medical emergency, it should be addressed promptly.

Port Problems

Rare port complications include infection (usually skin bacteria in your pores contaminate the wound), seroma, which is a collection of sterile serous fluid, hematoma, which is a collection of blood. Breakage of the port can also occur though the Lap Band device is guaranteed. Natural body movements can also cause it to break. This is very rare and is usually related to a specific event. Port replacement can be done under local anesthetic as an ambulatory procedure. Port leaks are rare and are usually related to the disconnection of the device or a needle stick.

Always call your doctor and advise him (with the truth)! In the case of an emergency, please call 1.866 Dr Ortiz ext. 5 |  (1.866.376.7849 ext. 5)