Enlarged Stoma Advice

Hello there. I had RNY gastric bypass in 2010 and lost over 200 pounds. I had a hard time losing the weight after around 3 or 4 months after surgery, but I continued to lose weight by restricting my calories and increasing my exercise. Around 2 years ago, I started to steadily gain the weight back. I found out in November that the connection between my stomach and the intestines (the stoma) is too large. I am looking for some advice. I am never satisfied after eating due to the enlargement. I can eat pretty much anything without getting dumping syndrome. I have talked to a bariatric surgeon about getting a revision, but there is a 3 month weight loss trial before I can find out if I will be approved. The surgeon wants to see if I can lose the weight on my own without the revision. I have been giving it my best effort, but the moment I start to feel satisfied the contents of my pouch or sent into my intestines and I'm left feeling either neutral or hungry. I want to be as successful as I can during these 3 months. I am not sure what and how to eat to try and trick my stomach into keeping food in it longer. I have tried fiber rich foods, high protein foods and frequent meals, but I am left feeling hungry all the time. Any advice would be appreciated. I would also like to hear from someone who does have this same problem and what sort of things they eat on a regular basis.

Thanks so much in advance!

Charity

What sort of revision are you wanting to have? Things like the ROSE, the POSE, the StomaphyX, etc., just don;'t seem to give good long-term results. The Apollo Overstitch is pretty new, and *seems* to work better---but it's still no miracle cure.

Have you researched having your failed RNY revised to a Duodenal Switch? This is the most complicated (for the surgeon, not the patient) revision out there, but it's also the most successful, long-term. It would give you back a fully-functional stomach, complete with the pylorus. It would also give you life-long malabsorption of a significant per centage of the calories you consume.

MsBatt, did you have a DS or a RnY to DS revision?

I had a DS, no revision.

Hi there. I haven't been offered any method yet. I have to complete 3 months of weight loss trials before they will even talk to me about what options are available and if my insurance will cover a second procedure. I have done a little bit of reading, and from what little I have read so far, the stitching seems to be only a temporary fix. I am very concerned about this being an ongoing problem for me.

I'm in the process of a distal rny revision. I have GERD, so the DS is not an option for me. I'm on a supervised 1200 calorie diet and increased activity by the dietitian. I started early Oct and have lost 4-lbs. My issue is metabolic. Prior to the diet, my dietitian estimated I needed 1600 calories to maintain my weight of 231-lbs, so at 160 lbs (BMI of 25) I would need 1050 calories to maintain. Yikes!

I kept a diary of my diet, activity, hunger etc. This is what I did with the diet. I increased my protein to 100 gms, cut out all simple carbs (which can make you hungry quicker), ate around 100 gms complex carbs and the rest is fats. Also increasing my protein has helped with some of my hunger.

I was worried like you. When I saw my surgeon and dietician after 2 months, they could tell I was trying very hard.  But they wanted an additional 2 months to make it easier to convince my insurance company. I will go back early Feb.  I have not been scoped, but I have restricition after 10 oz of food. 

I wish you luck in your journey. Donna

Hi Donna! Thank you so much for your response. I don't know anyone else that has the same situation so its quite refreshing to know that someone else understands. My dietician does not have me watching my calories but wants me to keep my carbs limited to less than 120g a day. I have been getting over 100gms of protein of day and keeping my carbs as low as I can in an effort to stay full longer. I have only noticed a very small effect on my hunger. I still need to eat every 2-3 hours or I will be physically hungry. I'm not sure how else to adjust my diet to meet the needs of my situation.

I was wondering how long do you wait after eating before drinking fluids?  I try to wait 1.5-2 hrs, because I don't get hungry as fast. This allows me 1.5-2 hrs to get 16-24 oz fluid in between meals. I try to get between 90-100 oz of fluid a day.

I have noticed that if I drink anything at all, I immediately feel as if my stomach is emptied. I think you might be on to something with the waiting period. I use to be very strict with the waiting period after surgery, I need to get back into that habit!