Question:
What determines weight loss success inspite of a large stoma?

I am only 4 weeks out from LAP RNY, but from day one I could eat/drink continually without ever getting full, nauseated, or dumping. I am usually hungry again 1/2 hour after eating. I'm thinking I might have to face the fact that I have a large stoma. I will just have to wait and see about that as I get closer to being 6 months out or so, then if I'm still this way, ask the doc for an upper GI. Anyway, what I am wondering is whether weight loss in people with large stomas doesn't occur because they overeat? Or is it some other mechanical factor related to the rearrangement of the GI tract? Some people have RNY revisions done, but are they ever done to correct a large stoma? I get the impression from what I've read here that trying to correct a large stoma with more surgery is dangerous, but I don't know how or why. I guess I'm trying to weigh (pardon the pun) my options if I do have a defective stoma. If I stick to an 800 calorie a day diet, even though I am hungry, will I still lose weight in spite of a possible large stoma problem? Any comments are indeed welcome! God bless!!!    — Deborah L. (posted on March 18, 2004)

March 18, 2004
What does your doctor say? I know that around 4 weeks out I hit a plateau, which I was warned was normal. And, at 800 cals a day, anyone would lose. I'm 10 months, probably around 1000-1200 a day and still dropping. I'm not picking here, but are you sure the hunger you're experiencing isn't head hunger? Hugs and luck!
   — lorien

March 18, 2004
Deborah: Please check with your doctor immediately if there's any thing you're unsure about. He/she needs to know all of your concerns right away. You should not have to wait 6 months to be sure your surgery is mechanically sound. Also, please remember that often, new post-ops do not develop feelings of fullness right away. That was the case with my son. We were all concerned that he seemed able to eat much more than he should have. Within 5 weeks of surgery, his feelings of fullness developed and all was well (he's lost 170 pounds since May 2003). Good luck, and please call your surgeon today.
   — Carlita

March 18, 2004
Can you loose weight with a large stoma? CERTINALY!! I lost a total of 150 pounds. A large stoma will render your pouch non functional; but the rest of your RNY is working. YES I guess its possible to 'slow' down some of the weight loss (im sure mine would have been more) if you 'overeat'. A stoma problem is a "RNY" problem. It is avoidable having the DS. Can it be fixed? yes, BUT it can also be hard to 'find' a surgeon to fix it. When I was diagoised with this problem 3 years ago; there wasnt any information here. I finally heard from the Bariatric Association and was told surgeons had know about this problem for years, failed to fix it so MOST refert their paitents to 'diet and excerise' YES diet and excerise work.. but DUH if I could 'just diet and excerise I wouldnt have had surgery in the first place. The pouch is a BIG portion of the surgery if it wasnt important then why do it all.. it also plays a part in maintenance. It took me three surgeons before I found one that 'fixed' me. One option (in place of actually triing to surgical fix the stoma which can be dangerous... ) is having your doctor put on a lap band. My doctor was sucessful in this. and after having it activated (i.e filled) I now have food restrictions for the first time since 2000. Also, there is a GREAT article in this months issue of "beyong change" about the stoma problem. The SAD thing is that surgeons are STILL not letting people know that this could happen to them. I am glad that I and others are being vocal about this problem, and its 'getting' out there so people dont think its 'them' when in fact, it could be a stoma problem. Strictures are KNOWN doctors tell their patients they could have this problem. A large tsoma is just the 'opposite' of stricture. and IT does happen. Good luck. IF this is your problem, its not an easy road to travel.. but you can make it thru....
   — star .

March 19, 2004
Please don't wait to speak to your surgeon about this. At 4 weeks, I could barely feel anything but numb in the pouch area, so there was no way to 'tell' if I was full or not. I had to just watch the quantity I ate and stop when apropriate. The 'full' feeling did kick in eventually, but it's not the same full feeling I used to have. You really have to pay attention to your body and it's signs. Hunger, well, that's another issue altogether. It has to be dealt with tough. Are you hungry? Really? How do you kow? You can't have the same hungry feeling as before, just as you can;t have the same full feeling. So, what signified hunger now? You may need to address that. All this takes time and practice. Don't be discouraged so soon. Keep trying and speak to your surgeon. An enlarged stoma is not THAT common, that you should just assume you have one. But, if you feel something is wrong, you should address it now.
   — LMCLILLY