How do you stretch your pouch?

 Another topic about liquids stetching your pouch got me thinking - how do you stretch your pouch?

Eating too large of volume for your stage of recovery (being 2 months post op and restriction of 2 oz per meal - but you decide you want more so frequently eat 6 oz or so.)  Wait and move forward with type of food and quantity until your surgeon/dieticians plans tells you to.

Not chewing well enough - big bites of food in the pouch being forced through.  Remember there is very little acid in the pouch to break down food - that's why we chew, chew, chew.

Drinking fluid within 30 minutes of eating.  The fluid pushes the food through and can stretch pouch/stoma.

Maybe you will get other suggestions.

Well, it stretches naturally some over time.  It's supposed to.

If you eat far too much over and over again, though, you could stretch it more than it should be stretched.

You can NOT stretch it with liquids, including carbonated drinks. 

 Can you tell me about carbonated drinks? Is it bad to introduce some carbonation back into our diet? Does caffiene free diet soda count as water serving? Do a lot of people have trouble with carbonation? What is it about it? Air?

The air in carbonated drinks give some people gas.  Maybe just a little gas and maybe a lot of pretty painful gas.  Doesn't bother me at all, though.

Some people think carbonated drinks will stretch their pouches.  They think somehow all the gas builds up in there and stretches things.  That is not true, though.  There is an opening at the top of your pouch where food and drinks go in and an opening at the bottom where you used to have a pyloric  valve but don't anymore.  As soon as you drink something, it starts running out of your pouch into your small intestine, so the gas from carbonated drinks cannot build up in your pouch.  It's a pretty popular myth, though, for some reason.

I count all decaf drinks toward my 64 oz of liquid so I guess decaf diet soda would count.  I almost never drink soda so I never really thought about it.  I don't see anything wrong with having diet soda once in a while.  All the chemicals in it make it not a good thing to have a lot of, but that's true for people that haven't had RNY, too.

 Thanks so much for the info kelly! I appreciate you!

According to my surgeon, it is actually very difficult to stretch the pouch beyond the expected enlargement that happens naturally.  The pouch is made from the least stretchy portion of the stomach (the area where it joins the esophagus and along the lesser curature of the stomach), but is expected to enlarge as it heals and matures.  (If it did not, we would all starve to death trying to exist on only 2-3 oz of food at a time once the fat is gone.)  If anything gets stretched, it is usually the stoma, but my surgeon's experience is that, even in people who have come back because of significant regain, less than 20% of people have a pouch OR stoma that is enlarged beyond normal expectations.  That means that in 80% of the cases the regain has nothing to do with the pouch or stoma, but is solely because of what the person is (or is not) eating and their exercise habits (or lack thereof).

I personally find it unconscionable (and borderline unethical) that some surgeons actually try to scare their patients into compliance (both in terms of eating food and sometimes in terms of drinking soda) by "warning" of pouch stretching. 

Lora

Makes me feel better too. I worry about that. But I can tell instantly when I am full and I always stop eating.

It seems to me the most common way to regain at this early out (or to stop losing) would be to graze on high calorie food. And later on probably the same thing.

 Lora, that makes me feel a lot better.

I feel so bad for people *****ally stress out over whether the slightest little indiscretion of eating or drinking will stretch their pouch and somehow "ruin" their surgery.  This journey is stressful enough without people wasting energy worrying about something that truly only happens pretty infrequently.  I wish people could expend that energy in a positive way building healthy, new eating and exercise habits!

Lora