This page sets out the most common problems patients with AGBs encounter, and what solutions can be found.

A fundamental rule to remember is that the band around the top portion of the stomach will inevitably "squeeze" the stomach tissues - the higher the filling system's filling volume, the larger and harder the band's "tire" will be, and therefore not only will the ability of food and drink to pass into the main portion of the stomach beyond be reduced but also the part of the stomach wall in immediate contact with the band will be "strangulated" to some extent. Biological tissues tend to react to a sudden change of this nature in a perhaps surprising manner: by becoming inflamed and oedematous, i.e. water-logged, and this actually increases the pressure and makes the situation worse, until the inflammatory reaction subsides after about 48 hours. That is the reason why many fill providers are quite anxious about giving too large fill steps - with a little bit of bad luck, an emergency defill may have to follow!

In fact some patients fail to realise (or maybe are never told) that a severe degree of excessive restriction may develop into a life-threatening situation when neither food nor liquids can be swallowed (not even your own saliva!) and the resulting dehydration can eventually cause kidney failure. Excess restriction is always a worrying development and needs to be discussed with a fill provider who can, if necessary, defill the band if there is no sign of improvement. Unfortunately this requires expertise and access to Huber needles, neither of which is readily available in every hospital!

Although it may sound difficult to believe, the band can actually be influenced by the body around it; this explains why patients not infrequently discover that changes such as having a period, catching a cold or travelling by airplane or across a vertical distance can suddenly cause marked changes in their restriction! Also, weight loss itself - although a relatively slow process - can cause restriction changes. As mentioned above, a tight band may cause inflammation in the stomach wall underneath the band, and if serious discomfort persists despite a partial defill, then a course of acid blockers may help as the stomach's own acid can start to attack an inflamed stomach wall from the inside... 

Because the oesophagus (the gullet) and the stomach itself are designed by nature to actively advance food "down the line" through a wave of muscular contraction (called peristalsis), patients with AGBs may find that with tight restriction they can still swallow food (which is solid and therefore will be gripped and propelled beyond the band by the peristaltic movement) but not liquid (which is too "elastic" for peristalsis to get a grip on). That means that in case of temporary severe restriction, the need for an emergency defill can sometimes be avoided by eating sodden solid food or semi-solids.