After Roux-en-Y Gastric Bypass Surgery
You Are Not Allowed to Drink
with or
Directly After Your Meals.
Why?
The rule is: No drinking with meals or for 30 to 60 minutes after each
meal. But why??
After roux-en-Y gastric bypass surgery we are given the rule of not
drinking with meals or for 30 to 60 minutes after a meal. It is an important
rule, but do you understand why it is so important? "The RNY Rules" attempts to
help you understand the reasoning behind specific rules set up by nutritionist
and bariatric surgeons.
Before gastric bypass surgery you had the pyloric valve at the bottom of
your stomach to keep food inside the stomach while it began the digestive
process. As food was digested and ready enough to be released into the
intestine, the pyloric valve (a trap door, really) would open and let a small
amount of food out of the stomach and into the small intestine. Digestion would
continue in the stomach, the trap door would open and a bit more food would be
released. And on and on... This process can take 2 to 3 hours in a normal
stomach.
After RNY gastric bypass surgery the pyloric valve is no longer part of the
newly formed stomach pouch. It remains at the bottom of the stomach which is
bypasses.... So we don't ever use the pylorus again.
With our new pouch we have to mimic the action of the pyloric valve
manually and the only way to keep food in our pouch (which is basically a funnel
now, with no trap door) we have to eat dense foods and not mix that food with
liquid. The denser the food, the longer it can stay in the pouch. Food can stay
in your pouch for up to 1.5 to 2 hours if you don't drink water. The minute you
add water (or any liquid) to the mix, you are creating a "soup" that will
quickly empty out of your pouch.
About 40% of the digestive enzymes our food needs to be broken down is
contained in our saliva. Our pouch does not produce gastric acid (or
hydrochloric acid) anymore, so the saliva enzymes are all we have to work with
here... Which is another reason why need to chew, chew, chew really well. Once
food gets to the pouch, those digestive enzymes go to work on the food to begin
breaking it down (mostly carbohydrates). Our pouch doesn't churn as much as our
old stomach used to, but there is still some movement with that well-chewed
food. The longer it stays in the pouch, the more it is broken down and prepared
for the intestines to do their work of grabbing nutrients from the food. If we
wash the food out too quickly, the intestines can not as easily absorb the
nutrients from the food we eat because it passes too quickly undigested. (This
can also increase the risk of constipation and intestinal blockage.)
Of course with your pouch being empty you'll get hungry sooner. For new
post-op gastric bypass patients, this isn't necessarily a big issue because the
hunger hasn't returned yet. But for those further out from surgery, the hunger
can be ravenous and you want to keep food in that pouch for as long as possible.
That's why it's recommended that the further out you are from surgery, the
longer you wait to begin drinking after meals (60-90 minutes).
SO... besides all that, there's the risk of stretching the stoma (the
opening between the pouch and intestines). If you have dense food that has not
begun to be digested in the pouch and you drink water you are FORCING that dense
food to be pushed through the stoma prematurely. That opening is only about the
size of a lady's index finger, but if you push food through the opening before
it's ready to go, you'll eventually stretch that opening. This is FAR more
worrisome than stretching your pouch. Once it's stretched it can become the same
diameter as the pouch itself... essentially creating one big long tube that food
can be packed into at meals. Basically a 20-foot long stomach.
This caution from surgeons is NOT a scare tactic or some random rule made
up to torture gastric bypass patients. This is about biology and medical
science. You now must manually do the work of the pyloric valve because you
don't have one. And it's about preparing your food so your body has the best
chance of absorbing the vital nutrients it needs for survival.
Since my RNY gastric bypass surgery almost 18 months ago, this is the one
golden rule that I have follow with extreme dedication. I've lost 113 pounds and
hunger is not a major issue for me. I truly believe this is a rule that I can
easily follow for the rest of my life and because I understand the science
behind the rule, I'm more willing to make it a priority
.
Written by Pam Tremble and posted HERE
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