Has My Gastric Pouch Stretched?

by Diana
(Oakley, CA)

I had gastric bypass 10 years ago and lost a total of 90 lbs. I am going through menopause and started taking Prozac. Since then, I have gained thirty pounds! It seems like I gain a pound every week. My energy level is so low that I am having difficulty exercise.

How can I tell how much my pouch has stretched?

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Surgeon response to "Has My Gastric Pouch Stretched?"

by: John Rabkin, M.D., Pacific Laparoscopy

Diana,

Weight regain is unfortunately a common problem encountered by many patients years after losing weight following a Roux-en-Y Gastric Bypass.

In many cases as you infer by your question, this is related to increasing food ingestion and, therefore, caloric intake over time to achieve a sense of satiety (fullness) due to a gradual enlargement of the gastric pouch.

The size of the gastric pouch can be assessed by many methods.

It can be reviewed endoscopically by having an EGD, radiographically by having an UGI swallow study, or, more simply and in my opinion a more meaningful assessment, a 'calibration' of the gastric pouch capacity for food at a meal.

To make this assessment, I usually ask patients how much of a sandwich they can consume at one brief meal, with or without eating the bread, whether or not they consume chips or other condiments along with eating the sandwich, and if they drink fluids while they eat, in order to gauge the capacity of the enlarged gastric pouch.

Other factors also play a role in weight regain after Roux-en-Y Gastric Bypass such as enlargement of the gastrojejunal anastomosis, all of which should be assessed and considered in evaluating a patient experiencing weight regain following a Roux-en-Y Gastric Bypass.

John Rabkin,
M.D.Pacific Laparoscopy

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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Weight Gain After Gastric Bypass Surgery
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)

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