{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:14:33Z","timestamp":1771269273416,"version":"3.50.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T00:00:00Z","timestamp":1679097600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"US Department of Veterans Affairs","doi-asserted-by":"publisher","award":["#I01 BX004774"],"award-info":[{"award-number":["#I01 BX004774"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"US Department of Veterans Affairs","doi-asserted-by":"publisher","award":["#I01 BX005173"],"award-info":[{"award-number":["#I01 BX005173"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Candy cane syndrome (CCS) is a rare complication of Roux-en-Y gastric bypass (RYGB), in which the afferent jejunal limb is excessively long. Common symptoms include abdominal pain, nausea and vomiting. A 57-year-old female with a history of RYGB 15\u00a0years prior to presentation reported 7\u00a0months of persistent heartburn refractory to proton pump inhibitors. Upper endoscopy revealed a 9\u00a0cm blind, afferent jejunal limb. After the blind limb was resected laparoscopically, her symptoms resolved. Fifteen years is the longest duration reported from time of RYGB to symptom onset of CCS. Furthermore, heartburn is less frequently seen as a presenting complaint of CCS. Clinicians should thus maintain a high index of suspicion for CCS in patients with refractory heartburn and a history of RYGB, regardless of how long ago the RYGB was performed.<\/jats:p>","DOI":"10.1093\/jscr\/rjad130","type":"journal-article","created":{"date-parts":[[2023,3,18]],"date-time":"2023-03-18T22:35:30Z","timestamp":1679178930000},"source":"Crossref","is-referenced-by-count":6,"title":["Candy cane syndrome presenting with refractory heartburn 15\u00a0years after Roux-en-Y bypass"],"prefix":"10.1093","volume":"2023","author":[{"given":"Shahana","family":"Prakash","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Iowa Carver College of Medicine , Iowa City, IA , USA"},{"name":"Department of Medicine, Iowa City Veterans Affairs Medical Center , Iowa City, IA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramses","family":"Saavedra","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal , Minimally Invasive and Bariatric Surgery, Department of General Surgery, , Iowa City, IA , USA"},{"name":"University of Iowa Carver College of Medicine , Minimally Invasive and Bariatric Surgery, Department of General Surgery, , Iowa City, IA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal , Minimally Invasive and Bariatric Surgery, Department of General Surgery, , Iowa City, IA , USA"},{"name":"University of Iowa Carver College of Medicine , Minimally Invasive and Bariatric Surgery, Department of General Surgery, , Iowa City, IA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1402-580X","authenticated-orcid":false,"given":"Mohamad","family":"Mokadem","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Iowa Carver College of Medicine , Iowa City, IA , USA"},{"name":"Department of Medicine, Iowa City Veterans Affairs Medical Center , Iowa City, IA , USA"},{"name":"Division of Gastroenterology-Hepatology , Department of Internal Medicine, , Iowa City, IA , USA"},{"name":"University of Iowa Carver College of Medicine , Department of Internal Medicine, , Iowa City, IA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,3,18]]},"reference":[{"key":"2023031822352690100_","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.gassur.2003.12.023","article-title":"Roux-en-Y gastric bypass is the operation of choice for bariatric surgery","volume":"8","author":"Melvin","year":"2004","journal-title":"J Gastrointest Surg"},{"key":"2023031822352690100_","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.soard.2007.02.011","article-title":"\u2018Ccandy cane\u2019 roux syndrome--a possible complication after gastric bypass 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