What is efferent loop syndrome?

Efferent loop syndrome is one of two "loop syndromes" that can happen after some types of gastric surgery. In a loop syndrome, a portion or "limb" of the small intestine becomes blocked.

Of the two types of loop syndromes, the other type, afferent loop syndrome, is the more common. Efferent loop syndrome is quite rare. Surgeons have improved gastric surgery, so both types of loop syndromes are now less common.

What causes efferent loop syndrome after gastric surgery?

The blockage in efferent loop syndrome can happen because of a hernia within the small intestine, which becomes trapped and blocked. It can also happen because of blockage from an adhesive band or kinking. This is because of scarring or poor reconstruction during the weight-loss surgery. In some cases, part of your intestine may slide inside another part of the intestine (called intussusceptions). This is caused by an efferent loop blockage.

What are the symptoms of efferent loop syndrome after gastric surgery?

When efferent loop syndrome happens, it is often within the first few weeks after surgery. But it can also develop even years after weight-loss surgery.

As a result of the blockage, digestive secretions, such as bile and other digestive enzymes, build up in the intestines and begin to cause problems. Rarely, a rupture of the intestinal wall can happen.

You may have the following symptoms:

• Extreme, often cramping, stomach pain
• Nausea
• Distended stomach and pain relieved only by vomiting
• Vomiting large quantities of bile, a green digestive fluid

How is efferent loop syndrome diagnosed?

If your healthcare provider suspects that you have efferent loop syndrome as a result of a gastric bypass procedure, he or she may perform a physical exam, upper gastrointestinal X-ray, or a CT scan to look for the blockage. Healthcare providers will use an endoscope, a thin, lighted tube with a tiny camera at the end, passed through your mouth and into your intestines to confirm the diagnosis. In some cases, where the clinical suspicion is high, additional testing is not needed. The diagnosis is confirmed at the surgery.

How is efferent loop syndrome treated?

Surgery is needed to correct efferent loop syndrome and restore the intestines to healthy working order. Depending on how severe the efferent loop syndrome has become, the surgery may have to repair lesions, fix a hernia, close any anatomical defects, repair the intestine. It can possibly make changes or repairs to the gastric surgery itself.

When should I call my healthcare provider?

Contact your healthcare provider immediately if you have any symptoms of efferent loop syndrome any time after your weight-loss surgery.

Key points about efferent loop syndrome

In efferent loop syndrome, a portion or "limb" of the small intestine becomes blocked. Efferent loop syndrome is quite rare.

• When efferent loop syndrome happens, it is usually within the first few weeks after surgery.
• Common symptoms are:
  • Extreme, often cramping, stomach pain
  • Nausea
  • Distended stomach and pain relieved only by vomiting
  • Vomiting large quantities of bile, a green digestive fluid
• Healthcare providers will use an endoscope passed through your mouth and into your intestines to confirm the diagnosis.
• Surgery is needed to correct efferent loop syndrome.
• Contact your healthcare provider immediately if you have any of these symptoms any time after your weight-loss surgery.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

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