Question:
What is the cottage cheese test?

Are we supposed to be checking our pouches periodically? I think my pouch must be very small, because two bites for me, and that is it. It is embarrassing when you are out to eat, or with a group. Also, anything other than liquids or puddings makes me throw up. I will be glad when this gets better. How long will that be? I am two months post op and have lost 47 lbs, so I am almost halfway to my goal. I do not think I am eating enough. Most days I am so tired I can hardly make it.    — Melinda W. (posted on September 13, 2002)

September 13, 2002
hiya...i'm inserting the cottage cheese test. please email me directly - i have more information that i think can help you but it's too much to post here. (i facilitate a wls support group) {hugs} kate open rny 6-14-01 pre op: 268lbs goal: 135lbs current: 130lbs _______________________________How big is my stomach pouch? Just about every patient asks this question on occasion. It is expected and appropriate that the stomach pouch will enlarge somewhat as the months pass after gastric bypass. Some of this enlargement is an actual increase in size, and some represents a softening (regaining of elasticity) of the pouch and its outlet. The real answer is that the FUNCTIONAL size varies with many factors such as time of day, the amount of time taken to eat, mood of the patient, other medical issues, and (most importantly) the type of food eaten. It is expected and appropriate that the pouch will handle a much smaller amount of solid food (chicken) than mushy stuff like mashed potatoes or soup. The cottage cheese test is a technique that was presented at the June 2000 meeting of the ASBS (and many times before that) by Latham Flanagan, MD (website is at The Oregon Center for Bariatric Surgery). It is meant to be a standardized, reproducible measurement of the physical size of the stomach pouch in a person who has undergone a gastric bypass procedure. Purchase a container of small curd low-fat cottage cheese. Begin the test with a full container, and perform the test in the morning before eating anything else (this will be your breakfast on that day). Eat fairly quickly until you feel full (less than five minutes). Note that the small soft curds do not require much chewing. The idea with the rapid eating is to fill the pouch before there is much time for food to flow out of it. After eating your "fill" of cottage cheese, you will be left with a partially eaten container that has empty space where cottage cheese used to be. Start with a measured amount of water (16 ounces, for example), and pour water into the container of cottage cheese until the water is level with the original top level of the cottage cheese. Voila - the amount of water poured into the container is the functional size of the pouch.If this is your first time doing the test - DON'T PANIC. You are likely to find that the "cottage cheese" size of your pouch is way bigger than your surgeon told you he/she made it at the time of surgery. Dr. Flanagan's data indicates that the average size of the mature pouch by cottage cheese test is 5.5 ounces. He has also found that sizes ranging from 3 to 9 ounces have NO IMPACT on the person's success in weight loss.
   — jkb