Oesophageal Patients Association
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8 months post ivor lewis

Hi all again,

Is there anyone who continually have or had problems with the pyloric muscle?

Every time I get a problem with it I lose my appetite/ struggle to eat and drink. Long story short after contacting my specialist team I'm booked in for a dilatation. But whilst waiting for the appointment I lose more weight and end up in hospital dehydrated and malnourished, this has happened 4 times now. My weight has been a concern since the operation, never been able to put weight on and losing weight every time I have an issue isn't ideal. My surgeon suggested nj feeding which I agreed to and now have and slowly putting weight on but I'm concerned about what happens after they remove it also I'm booked in for another dilatation on the 15 th Oct but this time I'm also having botox injections in to the pyloric to relax the muscle. Has anyone else had this done and does it reduce the problems I'm having with the pyloric muscle?


5 Replies

It is not uncommon. It is important for the pyloric sphincter to be able to be open enough to enable a good flow, but not so loose as to risk too much bile reflux. If the food backs up you feel nauseous. I think you are right to concentrate on the importance of keeping up hydration and nourishment, but this is easier said than done. Some people have several dilatations before it settles down. I am never sure why some people get affected more than others; perhaps it is an effect of the surgery on the vagus nerve system that might be affecting things, but I do not actually know the answer. But it is a relatively straightforward complication after the surgery that is normally adjusted OK afterwards. This may not make you feel any better at the moment of course, but it is not a sign that anything has gone wrong with the surgery. Meanwhile try and keep up nutrition with liquid food etc.


Hi Leon

My wife had her IL over two years ago, after some very difficult and challenging early days, she is now doing really well.

She also had some problems with her pyloric sphincter. I read a number of books early on to see what we could do to help her health improve. Whilst reading the information sheet that come with the PPI she uses, I read that PPIS can lead to the poor absorption of magnesium. This caused me to buy a book called the magnesium miracle. In short PPIs frequently lead to low magnesium levels that cause all manner of difficulties. One of the things magnesium is essential for is to allow muscles to relax (also essential in energy cycle). Any way my wife (and me) take magnesium oil (10 sprays on each thigh each evening). Touching wood my wife has not needed any further dilutions. You can see my thoughts around the connection with the pyloric sphincter and the importance of magnesium levels and allowing muscles to relax.

I'm not saying it will work for you, but magnesium oil (it's absorbed through the skin) can't hurt you, if you have too much the worst it can do is make you a bit loose.

You can get magnesium oil From Amazon for about £8. Last you a couple of months.

Hope this post is helpful.

Hope thing get better for you quickly, I'm sure they will!


1 like

Hi Leon, I had my op at the Derby Royal in march carried out by Mr Iftikar.

Apart from a problem with oxygen levels which meant I had to go back to intensive care for four days it was a success. However like you I had a lot of problems keeping food down with out vomiting and lost weight. After speaking with Cancer Nurse specialist I was given a cat scan and gastroscopy carried out by surgeon. Thankfully both came out clear with no need for dilation. The advice was to cut food up vey small. Also I saw my diet advisor to discuss how I could improve things. Now my wife makes scones using fortisip and jelly with fortisip. At present I have gained 2lbs which is a start. Origonally I was 13.5 and am now 10.8. For me the worst part was chemo as I now have DVT in my lower left leg which meant I had a filter put in before the op. Now out. I always think of something Alan said that we now have a different plumbing and it takes time to get used to and settle down. One last thing is that my GP prescribed me citipram which stopped me getting so anxious about swallowing

I wish you well and am sure it will come right for you.



I also had my ivor Lewis at Derby by Mr awad. Mr iftikar did my second op when I had a kyle leak


Hi Leon

Do you know where the leak was, which required the second op?

What are they dilating - the anastomosis which is the join between the pulled up stomach tube and the stump of your former eosophagus or further down at the pyloric sphincter exit from your former stomach?


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