Rules of The Pouch-Revisited

Thanks Lisa. It helps to see this laid out this way.

Hi Joanie, I am 6 months post-op and have lost 103 pounds. I have never heard of these rules. One doctors rules are not necessarily anothers. I would suggest to anyone who has never seen these rules to consult YOUR own doctor before putting these "rules " into effect. Good Luck everyone, Sarah

Sarah- you should know that thes are not rules of any particular doctor. They are the 'rules' as set forth from a specific scientific study of Gastric Bypass patients. I don't have the details at my fingertips, but a search of "Pouch Rules" Or Pouch Rules For Dummies" will yield you the info. It is my understanding that most surgeons base their recomendations on this study as well as thier personal experiences. Best wishes, Lisa C

Thanks for posting these Joanie, I find the "water loading" really helps me during the span between lunch and dinner due to my crazy work hours. I have breakfast at 2:30 am, a snack at about 6:30 am and lunch at about 10:am. Dinner is the only meal we have as a family and I enjoy sitting down with the crew and catching up. Have a great day! Julio

Thanks for posting about this Joanie and Lisa, I have had a really hard time trying to pu****er loading into practice. I now realize I was drinking much too fast (guzzling) and the pain was unbearable so I stopped doing it. I took the "drink as much as possible as fast as possible" a little too literally. I am going to try this tomorrow by more frequent sipping and see how I do. terri

The pouch rules for dummies, like the ideal meals rules, are simply recommendations of particular surgeons-- they are not, hard and steadfast rules unequivocably supported by reams of non-contradictory evidence. For instance, water loading is not universally accepted because of the belief among some (which is not my belief, but it is a position which I appreciate) that it does not teach the post-operative patient how to truly sense satiety from the food that is eaten. It does help me to feel full and to eat less (which has helped to sustain my 300+ weight loss)-- but I have spoken to post-ops who feel that they want to feel fullness from the food they eat and not a phantom fullness from the water they have consumed and they are willing to whiteknuckle through the slight hunger pangs that may follow the end of their strictly time-limited meal that was not preceded by water loading. Also, the 90-120 minute rule for separating fluid intake and food is also difficult for some, because, although a single 90 minute period will not cause dehyration in someone consuming appropriate amounts of fluids, over the course of a day, a patient who waits 90 minutes before and after her 30 minute meals to consume any liquids is taking 10 1/2 hours out of their daily 16 waking hours when they are not drinking-- and, leaving only 6 hours to stay hydrated can promote dehyration in some. And the 90 minute separation rule is directly contradicted by the alleged universal truth of water loading 15 minutes before each meal. Certainly, it can NOT be universally true that one should avoid drinking for 90 minutes before each meal and also that one should drink fluids 15 minutes before each meal to reduce the amount of food that is eaten. There are many universal truths for gastric bypass patients-- that we need to separate eating and drinking, that we need to learn to take small bites during meals that are limted in duration, that we need to promote a diet premised primarily on protein and that we need to learn how to control snacking and to eliminate grazing. But, how we implement those obejctives is less the result of adapting our experiences to alleged universal rules than it is finding the strength that comes from applying the bright line rules that are needed to help us overcome the the unhealthy relationships we have had with food that are particular to our past struggling with obesity.