Question:
What Happens to the old part of the stomach?

Can the old stomach fill up with acid and get ulcers or feel hungry? How can it just be there and not function? Does it atrophy or shrink up?    — Glenda E. (posted on July 8, 2000)

July 8, 2000
It is my understanding that the old stomach just sort of stays there and produces acid and mucous and does part of the job it used to do. It just cannot digest food any more. It doesn't shrink or atrophy or anything. The hungry feeling takes place in the area of the pouch, apparently that's where the sensors are and you have control over that one! Yes, you can get ulcers in that sealed lower stomach, but it is rare. For someone like me, lifelong hisotry of ulcer, not so very rare! Upon revision, I asked them to remove the old stomach completely. I am MUCH happier now than with my original surgery!
   — vitalady

July 8, 2000
Glenda: Here's my understanding: The 'old' stomach can get an ulcer, in fact, you have about a 30% chance of getting one after weight loss surgery unless your surgeon performs something called a 'vagotomy.' A vagotomy is the cutting of two nerves to the stomach - this surgery reduces your chances of getting an ulcer to only 1 or 2%. My surgeon, who is a founding member of the Bariatric Society and has been doing these surgeries since the early 1970s without losing a single patient, ALWAYS performs vagotomies on his patients. He also places a 'marker' on the old stomach just in case a doctor ever needs to scope that old stomach in the future. The marker will lead the doctor to the place where they can enter the old stomach to check it out (say for an ulcer or cancer or something). Sometimes, I'm told, they 'anchor' the old stomach to something so it doesn't float around and get tangled up with something. LOL But, as far as I know, the old stomach has nothing to do with your feelings of hunger - that's the new stomach and that's a wonderful side-effect to this surgery. It does continue to produce gastric juices and they work on the food you eat at the point where the two pieces of intestine intersect (the Y in the Roux en Y). These acids continue to form and flow from the old stomach which is shrunk up alot very soon after the surgery. Sometimes the doctor will leave a tube in the old stomach for a couple of weeks and it is called a gastric tube. You will probably hear about it. Its purpose is at least two-fold: one is to drain and deflate the old stomach; another is to provide a way to get nutrition into you in case there are some problems with your surgery. They used mine to give me some medications while I was in the hospital. It doesn't hurt when it is removed. Mine was removed when my staples were removed. I hope this info helps you - and I hope that all pre - op patients will ask their surgeons about the vagotomy.
   — Cindy H.