Abstract
Approximately 5 - 10% of RYGB patients develop anastomotic ulcers at the gastrojejunostomy. Published evidence on the incidence and management of persistent/recurrent and treatment-refractory ulcers is limited, but research suggests eight weeks of 40 mg daily PPI (proton pump inhibitor) therapy may be insufficient (ulcers persisted in 42% of non-smokers and 77% of smokers after two months of PPI therapy; three to six months of treatment are recommended [Marshall et al., SOARD 2006, 2(3):327]). Yet, even after up to 12 months or more of PPI therapy, a few of our patients presented with bleeding and/or penetrating ulcers that required surgical intervention.
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