Can your stoma be to big?

Ok, so I am now closing in on three months post op. I have lost 82 pounds. I don't feel like I have had any real problems and I have been super happy with my surgery. However I do have a question for some of you that are further down the line. When I eat dense foods I get a full or uncomfortable feeling and I know it is time to stop. The feeling usually passes very quickly and I could probably continue to eat but I never do. When I drink or eat less dense foods (hamburger soup for instance), I hardly ever get that same feeling. I feel like I my stomach drains very very quickly. For instance I can do my cardio and workout then grab a 20 ounce Isopure and down it in about 10 minutes by just taking small drinks constantly. Is this anything to be concerned about? I don't really feel like it is, but I hear so many people say that they can barely drink that I am starting to wonder. Can your stoma be to big, does it just take more caution if it is? I dont think there has been much talk about this here on the mens forum. Thanks, Troy

Troy, I really don't know if your Stoma can be too big or not.  That would bre a question best answered by your surgeon.  However, I think you may be concerned about nothing at all when it comes to how much you can drink and how quickly. I am currently 16 months post op and have lost 234 pounds.  Almost immediately post-op I was able to drink fairly quickly and large amounts.  Also, as you mentioned foods which are less dense seemed to go through more easily.  I was told to eat 2 ounce meals and did.  If I ate that amount of burger, fish, peanut butter, etc I would get that tight feeling and knew I was full.  However, when it came to things like yogurt I could eat a 4-6 ounce cup with no problem.  In fact, my surgeon told me to count things like yogurt and sugar free pudding, etc as liquids. I work in a factory and drink water quite heavily while I am working and even outside of work.  In fact I have many days where I consume as much as 400 ounces of water/liquids in a day.  My bloodwork actually showed that I was a little "wet" as the doc put it, or over hydrated.  Which he said was not a bad thing. Your weight loss so far is fantastic and I think you are right on track.  You should be congratulated.  But if you are really concerned about your Stoma size then I would again suggest contacting your surgeon. Keep up the good work. Steve

Steve,

400 ounces? I would watch out for water toxicity and similar problems. Can be very dangerous, but it appears to depend on the speed at which you drink:

http://chemistry.about.com/cs/5/f/blwaterintox.htm

Dave

Dave, Not really worried abou****er toxicity.  I am aware of it but rather than chugging huge amounts of liquid I just drink constantly throughout the day.  Also, I work 11 hour shifts in a factory where it is quite hot and I sweat quite a bit.  Of course on cooler days or when I am not working I drink less but still average 200-300 ounces even on my off days.  Maybe I should ease up a bit though.  Would definately cut down on the amount of time I spend ******g each day. Steve

Great question. I've been wondering the same thing.  I'm 2 months out and can comfortably drink a half-liter bottle of water inside of 5 minutes.  I'm also concerned about the size of my pouch. I hear all these people talking about eating the equivalent of a pack of cigarrettes or the volume of a shot glass and I'm thinking, "Damn, I could eat a grapefruit, rind and all. How big is my pouch, anyway?". I'm currently limiting myself to an avg of about 1150 calories per day, and am not suffering to much hunger for doing so, but there have been days where I went 1800. I had kind of an off day yesterday and went 1650 and would've gone over 2000 had I not gone to bed slightly hungry. Why did my doc leave me with such a big stomach?

Liquid type foods such as chili, soup, soft beans, etc. (sometimes referred to as 'slider' foods) will exit the pouch much faster than more dense foods like chicken breast or steak.   Some doctors (like mine) use a larger ring when they create the stoma.   I've complained about it since day 1 that I thought my 'hole' was too big.   His answer to me was that the farther out I get the more efficient my body gets at processing and digesting food.   I do get full very quickly on the denser foods that I mentioned above.  

Honestly though, I really consider myself eating 'normal' now compared to pre-op where I could down a couple appetizers, 2 entrees and two desserts not to mention the copious amounts of Coke with the meal.   Now it's a bit of an appetizer, most of my entree and sometimes dessert.   Water as my drink now with an occasional Coke thrown in.

Liquids should not give you a problem and should give you a sense of restriction. But if you are concerned about this, talk to your surgeon. Tell Dr. Kim I said hello. A quick X-ray dye study of you drinking a milkshake will give you a quick answer. Taking the small sips is the way to go. Your pouch is designed to drain by gravity, that is how we surgeons construct it. Particulalry if your are working out, we do not want you to suffer thirst by restrciting your fluids. Remember to measure you food portions, then be done. Put the plate away and move on to your next task. You may be dealing with "head hunger", your brain telling you that there is room for more. Also remeber to feed or drink protein 5-6 times a day to stem real "belly" hunger. Given your weight loss and level of exercise activity, your body may start to demand more frequent feedings of protein to replenish the protein broken dwon with your workout. Your surgery is designed to make you full quickly when you eat solid food. If you are chewing your food carefully in to baby food consistency, it may be passing quickly, which is the correct mechanism. You are still in the discovery phase after your surgery. You and your body are still figuring each other out. Congratulations on your surgery, your exercise, and of course your weight loss. I bet you have gotten rid of health conditions you had prior to surgery.

Good luck to you and good health.

Dr. Dirk Rodriguez

Deaconess Hospital

Cincinnati, OH

Any information given in this message is general and not intended to address specific medical concerns. Always seek advice from your bariatric surgeon or personal doctor.

Ditto here - I can do the liquids and 'slider' foods in mas quantaty - for post opt. When I eat food the sticks and grabs - rice, pasta, pretty much all carbs - i can only eat a little and then feel bloated after. Even though I chew and chew, I get that bloated feeling.

But as always check with your Dr. if you have any questions.

Sean