too quickly a few different things happen.

The New Anatomy not to get into the habit of using slider First, if food is not properly prepared for
After RNY the pyloric valve is no foods as your main food source. optimal absorption (chewed well, mixed
longer part of the newly formed with enzymes) we risk having food move
pouch. It remains at the bottom of the Of course when your pouch is empty too quickly through our digestive track
stomach which is bypasses, so we will you’ll get hungry sooner. For new post- without the benefit of full nutrient absorp-
never use the pylorus again to control ops, this isn’t a major concern because tion. Second, if food is not well chewed or
the flow of food from the stomach to the hunger hasn’t returned fully. But broken down, we are also at greater risk for
the small intestine. for those further out from surgery, the intestinal blockages or constipation.
hunger can be ravenous for some and
Our new stomach pouch is shaped the primary way to stave off hunger is
like a funnel. Which is a to keep food in the stomach The Other Big Risk
larger bowl shape at the pouch for as long as possible. There's also the risk of stretching the stoma
top with a small narrow This is why it’s recommended (the opening between the pouch and
opening at the bottom. Dense food can that the further out you are intestines). If you have dense food that has
The food we eat is held from surgery, the longer you not yet begun to be digested in the pouch
in place in the larger up- stay in your pouch wait to begin drinking after and you drink water you are forcing dense
per portion of the funnel meals (60-90 minutes). food through the stoma prematurely. The
and gravity allows food for 2 hours if you opening is only about the size of a lady’s
index finger, but if you habitually push
to slowly flow out the The New Digestive
lower narrow opening at don’t drink water. Process food through the opening before its ready
the bottom of the pouch. to go, you'll eventually stretch the stoma.
About 40% of the diges-
That narrow opening is But the moment tive enzymes required to This is far more worrisome than stretching
called the anastomosis or your pouch. Once the stoma is stretched it
fully break down simple
“stoma” for short. you add water, starch-based carbohydrates can become the same diameter as the pouch
itself. This would essentially create one big
is contained in our saliva
With our new pouch food will quickly (known as ptyalin). To break long tube that food can be packed into at
meals. Need a visual? Stretching your stoma
we have to mimic the down complex carbohydrates,
action of the pyloric empty out. would give you a 20-foot long stomach.
protein and fat, our body
valve manually and the requires the addition of gastric
only way to keep food in This caution from surgeons is not a scare
acid and other digestive tactic. This rule is about biology and
our pouch is to eat dense enzymes normally produced
foods and not mix it with liquid. medical science because now you have to
in the stomach. But our new stomach manually do the work of the pyloric valve
pouch does not produce in any signifi- that has been bypassed. By following this
The Food cant amount of gastric acid or enzymes. rule for the rest of your life, you’ll properly
The more dense the food, the longer it This is one of the main reasons why we prepare your food to give your body the
can stay in the pouch. The softer and need to chew, chew, chew really well. best chance of absorbing the vital nutrients
more liquid the food, the sooner it will it needs for survival as well as achieve the
empty from the pouch. Dense food Once food gets to the pouch, the level of satiety needed to reduce hunger
can stay in your pouch for 1.5 to 2 digestive enzymes from our saliva and between meals. 2
hours if you don't drink water. But the the limited amount produced by the
moment you add water (or any liquid) stomach go to work on the food to
to the pouch, you are creating a "soup" begin breaking it down. Our pouch
Pam Tremble has Roux-en-Y in November, 2007.
that will quickly empty out of your doesn't churn as much as our old
She has chronicled her weight loss adventures (and
pouch. stomach used to, but there is still some
misadventures) at Journey to a Healthier Me at
movement with that well-chewed food.
Soft foods that slide straight through www.PamTremble.blogspot.com.
the stomach pouch are called “slider The longer food stays in the pouch, the
Permission is granted to copy and distribute this article
foods” and include things like yogurt, more it is broken down and prepared
for nonprofit, educational purposes if it is produced in
soup, pudding or ice cream. Although for the intestines to do their work of
its entirety and this authorship section remains intact.
these are good foods to consume in grabbing micro and macro-nutrients
Please contact the author for permission to use article in
the early stages after surgery, be careful from the food. If we wash the food out
a publication.

Tips & Tricks

• Be sure you’re well hydrated before meals to avoid excessive thirst afterward.
• During meals, simply don’t have a glass of water at your plate.
• To cleanse your palette after a meal, eat 2 grapes for dessert or brush your teeth.
• Look at the clock after the meal to calculate what time you can drink again.
• Use gum or mints to keep your mouth occupied and your mind off drinking.
• Be patient with yourself as you learn. This is a hard rule to follow, it take practice.