Dear Jaye: At this point, you are dealing with incomplete information without having the information on what kind of surgery your client had done & when. It's important in terms of her dietary & nutritional supplement intake. What is her food intake like? As serious as it is for anyone to have an upper GI bleed, it is a serious complication for someone who has had a procedure which limits the size of the stomach. Hopefully, she is in communication with the team who performed the bypass to let them know. Depending on when & where she had her procedure done, some of the groups continue to follow patients long-term including through pregnancy & beyond. There were some article citations dating from 1998-2005 but I can't access them here from the house computer. Usually, gastric bypass patients do not have problems with gastric reflux. Those who have GERD issues prior to surgery often find that the surgery (if it is a roux-en-y) offers a permanent solution as the surgery separates the section of the stomach that produces most of the acid from the upper GI tract. It is recommended that gastric bypass patients stay away from medications that would further decrease acid production or would increase GI tract transit time as the surgery already speeds food moving through the shortened GI tract. There is research available that there is a small minority of patients who do have ongoing issues after the surgery...your client may fall into that population. Or, if she had a vertical gastric banding (the older "stomach stapling") then she had a procedure that did not reduce acid production, and in time may stretch back out in size or tear out. She would be just as prone to gastric reflux as the rest of the world. It's essential that the mother take her vitamin supplements, including B12 & iron--not only to maintain her own health but her babies. There are also reports of infants who have had failure to thrive, seizures, developmental delays, & neonatal megaloblastic anemia due to their mother's inadequate diet and nutrition. I'm also concerned about what may have caused the UGI bleed. I'd be interested in finding out what she was taking prior to the bleed--OTC, prescription, herbal, as well as other gastric irritants such as alcohol or smoking. Linda Madsen, RN, BS & Lap Gastric by-pass pt in 2000 Wylie, TX *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome