Last week I received a stern warning from my surgeon about overeating and stretching the small pouch.
There was no joking about the subject, and he was seriously considering doing a barium esophogram at that point.. reason being is that I had a weight gain and I told him I could still eat a pretty good amount (2 slices of pizza).
At that moment, it became VERY CLEAR to me, that maintaining good pouch size and controlling head hunger will be the key to a successful weight loss.
The doc indicated that hewould give me a small fill, BUT that I need to adhere to the six small meals a day rule and respect the pouch volume. If I had any pouch enlargement (which only the barium esophogram would show) there is the likelihood that by following these eating requirements, the pouch could return to normal size. Just one bit of information (I did not experience any reflux or other adverse signs) so this supported his thinking that I was pushing the limits of my pouch size by eating larger amounts than prescribed.
So I went home and did my research (because I am a nerd like this..) and came across this .. Article on Pouch Enlargement which merely confirmed everything the doc told me.
Here is but a small excerpt that supports our discussion.
Pouch enlargement embraces the concept of concentric pouch dilation . The stomach wall stretches significantly. The band is pushed down as a result of the high pressure exerted by the dilated pouch. As a rule, complete obstruction is not associated with this entity. Therefore, it should not be considered a surgical emergency. The etiology of this complication can be attributed to both the patient and the surgeon. Factors linked to the patient responsibility are mostly chronic overeating and soda consumption . Perception often is distorted, and the concept of ‘‘overeating’’ needs to be redefined after the surgery. Overeating after LAGB placement means the ingestion of more than 4 oz of food per meal. With regard to the surgeons accountability, we believe that the adjustment technique is critical. Band overfilling is clearly associated with the development of pouch enlargement. For that reason, we advocate the practice of tailored adjustments. Interestingly, we realized that 28% of the patients in our series presented to our office requesting an adjustment mainly for the lack of restriction. No other symptoms were present. These patients would have undergone an adjustment according to the ‘‘office adjustment’’ protocol . Instead, complete band deflation was indicated. We strongly believe that tailored adjustments allow early diagnosis and treatment of pouch enlargement. Early diagnosis has enormous implications for the success of further treatments.
So for me.. I will be measuring my 4 ozs for each of my six meals.. no more guessing, no more gorging.. I have had my scare.. and have seen the light... be well..