A couple of questions for VSGers

I have a couple of clients who are in the process of getting approval for VSG and they have asked a couple of questions that aren't covered in the paperwork from our surgery group and that I don't know (even though I periodically read posts on this forum).  I had RNY, and most of my prior experience is with RNY and DS folks, both of which involve some type of intestinal bypass, so...

1) do many VSGers have issues with chronic constipation?

2) how long does the period of lack of hunger last after a VSG? (I realize there is probably LOTS of individual variation (there is with RNY), but I am wondering if it is generally longer than a couple of months as it is with a RNY.)

3) is there any negative physical response to eating a meal with too much fat?

Thanks for any info you can share.  We are getting an increasing number of VSG (or prospective VSG) clients, so I am trying to fill in the holes in my knowledge of the various surgeries.

Lora

1.  Constipation is a constant.  I take Miralax a few times a week and Fiber Gummies daily.  Without them, I've had some very painful moments.

2.  I'm only four months out and I still feel no hunger.  My surgeon says it's usually about a year before the hunger reappears.

3.  I haven't experienced a problem with eating too much fat; however, I've recently started adding it to my diet and have not had any side effects.  This includes healthy fats as well as unhealthy fats (fat from a nice, juicy ribeye)

I don't have the experience to answer your questions necessarily but I just had a long discussion with my surgeon (who I trust very much and who is very experienced) about #2 today. It's interesting because I've read on here that the benchmark for a lot of people seems to be 6 months, but he said he has patients who don't have hunger for a few years after surgery.  I am 3 months out and he told me it's not unreasonable to expect a year.  He also said, though, that the body compensates for the decreased calories and in his experience the trade off--having to work harder and have your body do less on its own--begins around 3 months.  Hopefully that makes sense.  For what it's worth :)

I'm a noob, I hit 6 weeks post-op tomorrow.  

1. I had constipation early on and have been taking miralax until recently, so I'm not sure if it's still an issue.  Next week I might have a better answer!  

2. Honestly?  I feel hunger now.  I don't know if my stomach is still healing - I feel like maybe it shouldn't be at this point.  But the hunger has a different quality, if that makes sense.  It's more of an awareness than the gnawing driving need that it used to be.  Again, this might change with time.  

3. Of course, I can't eat "too much" of anything right now since my stomach is TEENY.  But I've had no issues with the fats I have eaten.  I'm not taking any steps to eat low fat so I've had things like bacon butter on fish for dinner and fresh mozzarella balls.  No issues as of yet.  And I recently read an article about the benefits of fat in the diet to prevent your gallbladder from being removed, so I'll keep including fats in my diet!

6 months post op

1. Yes, constipation is definitely an issue. I use stool softeners, get my fluids in and am not regular..yet. I just started fiber gummies..I'm hoping that works.

2. I rarely have hunger cues. I tend to eat every 4-5 hours to keep my energy level up so I can go about my day without feeling lightheaded or tired.

3. I haven't put my sleeve to the fat test. I follow my surgeons dietary suggestions and that means dense protein first..my protein sources are white chicken meat, albacore tuna, ahi tuna, eggs, string cheese, beef jerky..all high protein, low carb and mostly low fat, too.

Colleen 

1) do many VSGers have issues with chronic constipation? Typically this is reserved for folks who follow the low carb path (particularly the less than 40 grams of carb group).  I personally only had issues with this when I was low carb, but once carbs were added back in and fiber was greater than 30 grams or so I never have issues.

2) how long does the period of lack of hunger last after a VSG? (I realize there is probably LOTS of individual variation (there is with RNY), but I am wondering if it is generally longer than a couple of months as it is with a RNY.) I am 28 months out and still do not feel hunger in the same way that I did prior to surgery. I do get a version of hungry when compared to a few months out. In the early months I would describe the feeling as being more like "empty" whereas now it empty plus a little hunger. I am never, ever ravenous though.   Head hunger is a whole different answer though.

3) is there any negative physical response to eating a meal with too much fat? I have not had an issue that is different from my preop experience.  Preop if I ate a heavily fried meal it would bother my stomach, and that has not changed.  But in general fat does not affect me if what I eat is not all fried (fried fish with a side of french fries for example). 

1) I only have constipation issues when I keep things super low carb. When I am eating more carbs, I am more regular than I was pre op!

2) For me, physical hunger still hasn't returned. (I will be 10 months out on the 1st) Head hunger on the other hand... That came back with its guns blazing at about the 6 month mark...

3) I recently experienced a negative "episode" when I had some full-fat ranch dressing (probably 2 tbsp total, if that) along with some baked chicken... I was running to the bathroom the rest of the night and into the next day! I don't typically seek out "low fat" options, and I've never really had any problems with it until this incident. Maybe it was a one-time thing, maybe not?

1. I had constipation once early out.  I added one of those fiber powders you can't taste to my diet and it was no longer a problem. don't remember when I stopped, it's been a long time since I needed it. so, no.

2. one week after surgery I had real hunger: one sip and I felt full. really, really full. after that, I always had hunger and it would go away but take more. I think this is pretty atypical.

3. eating too much of anything make you feel bad - fat seems to sit longer, like a brick. at least, early out. I always ate full fat, however, and still do. tastes better and I am full longer.

1. Constipation isn't a problem if I keep my fiber up. I would say my bowels are sluggish, but manageable.

2. If I junk out on carbs, my hunger spikes, but I recognize it as head hunger. Real, growly-tummy hunger? I only feel it if I haven't eaten in 5 hours or more, generally, but it's different than it was preop.

3. No, not really. I seem to feel fuller faster, and perhaps a bit less "sharp" afterward but I would attribute that to the fact that I KNEW that I ate something high fat. I wonder if I'd notice it in a blind study. I'm not sure.

Thanks for the work you do. :)

Laurie

1) I go very infrequently but don't have the same issues associated with constipation when I was pre sleeve. I don't have a lot of pain, or issues with the dreaded hemroids that one would normally associate with chronic constipation. That being said, I do take Smooth Move tea or Sennokot once or twice a week to move things along.

2) I am almost 1 year out and don't really get "hunger pains". Some days I have to remind myself that it's 4 and I haven't eaten half of what I should have by then. As long as I don't go withou****er. That is a bigger issue for me. I get lightheaded if I don't get my water in.

3) Fats actually work for me. When I add in some avocado or whole eggs or have a slightly fattier steak it helps in the bathroom department for me. Which is an absolute plus!

I suscribe to the low carb regime as per my surgeon. So...under 40 g of carbs, 80 protein and around 30 fat. I agree with HappyTeacher that obviously the lack of "high fibre" in my diet is what likely contributes to the infrequent bowels. I tried Miralax and Benefibre but I found they actually bulked up my stools and caused me more problems.