Since seeing a post of a new member who had surgery to 'tighten' her stoma, I am curious as to how you stretch it in the first place. I know how easy it is to stretch the pouch but I don't know how this relates to stretching of the stoma and why is that so bad? If the pouch still only holds a fraction of the amount your stomach did, why does it matter if the stoma is stretched? Just wondering for future reference.

The stoma is the opening where the food enters into your pouch. - the reattachment point of your intestine for us bypassers. The point of having a small stoma is the food enters your pouch slower and stays in your pouch longer thus helping you to feel satisfied longer. Over time, no matter what you do, your pouch and your stoma will give. This is "normal." That is why in the early post-op days you can eat 2 bites of food and feel satisfied/ full vs being one year out and eating 4 oz of food. You are still eating small amounts of food, but it is relative. The trick is to work your tool so nothing gives more then the "normal" amount. Sometimes surgeons make the stoma too small, which requires its own procedure to widen it - so that you can eat. Surgeons approximate the size to make the stoma taking into account scar tissue and "normal" give and thus create an opening that should in theory work.

Hope this helps answer your question. Wahooooo, I sound as if I know what I am talking about.

Marla knows what she is talking about---

also over eating and not chewing your food properly can also stretch the stoma---

Thanks both of you. That clarified things. I knew what the stoma is but I guess I didn't understand it's purpose.

Wow, I learn something new every time I read posts here. It's great!

Marla...look how smart you are!

Sometimes I wish that my stoma would have stayed itty-bitty. I tend to eat too fast and not chew enough this far down the line. Then it all hits me that I've overeaten...waiting for that signal like in the olden days (pre-op). That first year was easy because if you ate too much too fast, it would come flying back up! No more of that...

As we say in Bahston - I am wicked smaht.

Translation: As we say in Boston - I am wicked smart.



Thanks CAK!

That signal is fabulous, well and the foamies too. I love my itty bitty pouch and itty bitty stoma - hopefully they will stay that way if I keep loving them and babying them. I am glad celadon started this thread. It is important that we as WLS-ers understand as much as we can - especially about the inner workings of our tool!

just curious, i know the 5DPT can tighten our pouch back but can anything tightem the stoma back?

Well...I could be very wrong...but I don't think that can happen.

And from what I believe to be true (and again...I could be wrong), our pouches don't actually "tighten" after the 5DPT. We just re-learn what our pouches are capable of. We keep them empty for a couple of days and then learn to feel what "full or tight" actually is. Does that make sense? Am I wrong? Anyone???

As far as I know, there is no natural way to tighten up a stoma. It would require surgery.

Thanks for the info. It is good to know how every think works!

Mamma Kaye probably has the official answer to the 5DPT but I agree with Kim, I think this tool helps us get in touch with what the pouch feels like to we can "feel" fullness better. I think it's also shows the big difference between how dense proteins fill our pouches for extended periods of time compared to liquids and slider foods, therefore makeing us "feel full" longer.

Just my interpretation...

This just made me think of something that I shared here a while back. No idea where it is now, so I'll repeat myself!

My aunt (not a WLS patient) was at her local Weight Watchers meeting. There was a woman there that had WLS and was insisting that she had stretched out her pouch...it was most certainly broken, in her opinion. She was always hungry, yadda, yadda, yadda. She went to her WLS doc and demanded that a test be done to verify things. Well, he did...I think that it was a CT scan or some sort of test that showed the "hows and whats" regarding her insides. Guess what? The test showed that she was still in tip-top-shape. It all came down to the fact that she was eating "slider foods"...which you can find loads of at WW!!! We all know about those 1 point snacks!

The best part of the 5DPT is that we are all quickly reminded...without barium or any x-ray machines...that our pouches still tighten up around solid protein. I hate saying this, but it really IS...JUST A TOOL!!! We all have to conquer the monsters that got us to "obese" in order to get...and stay...at goal. Whether it be the carb monster, boredom, emotions or your spouse!!! Okay, that last one was a joke. You get my point though.

We all have to discontinue our "pre-surgery" habits.

Hi? I'm new here. Just want to ask anyone knew Julianne Kennedy? Well, she's giving a free report on Lap Band Surgery. Since you have read some books about it, I just want to lead you to here site. Don't worry her newsletter is for free download. I know some of here well think that 'm just suliciting or I'm just making nonsense. But it wount harm you for jut visiting her site. I just want to share what I have read and leanred about the site.

Well, for you to visit her yopu can check it here: http://www.weight-loss-surgery-secrets.com..._wls_report.htm

OK, not to be nit picking or looking for something to quibble over, BUT, the stoma is actually the opening from the pouch to the small intestine. Food enters the pouch directly from the esophogas and stays in the pouch until leaving through the stoma into the small intestine.

There is a new, non-invasive, technique for making the stoma smaller. It is done endoscopically. Below is a link to a surgeon that does the procedure in the Seattle area. They call it a ROSE procedure. Some insurances are covering the procedure. https://www.fhshealth.org/droh/default.asp

They are doing a study currently at Johns Hopkins of WLS patients who got to goal and have regained. These patients are examined and if the stoma has stretched, they are going to do a procedure to make the stoma smaller. Their project is called RESTORe. Here are a couple of websites about this study.
http://clinicaltrialsfeeds.org/clinical-tr...how/NCT00394212
http://www.ncbi.nlm.nih.gov/sites/entrez?d...;indexed=google

Hope this helps......

Doug, I pulled up the information on the Rose Procedure...and it printed fine. When I tried to look at the bottom two links, it brought me to a general page and asked for a search term. What do I put in there?

Thanks!

Good job, Doug! I caught the error about where the stoma is located earlier today, but didn't have time to reply. Then I forgot to come back.

Marianna:

My bad. Use the bottom link and when you get to the search page, use the term "gastric bypass stoma" You will then get a list. It's the second one down.

My bad.........

I just wanted to share the info I have acquired! The procedure Doug is referring to, I know by the name of Stomaphyx...as a matter of fact I have an appointment this Thursday with Dr. Bagnato at Palmyra Surgical in Albany, Georgia to discuss this as a viable option for me. If you want more info and a neat little video demonstration google Stomaphyx Palmyra and go to their homepage...on the left about halfway down you'll see info on stomaphyx. Dr. Bagnato is 1 of only 4 surgeons in the USA right now that can do this procedure. It is FDA approved, but so new most insurance companies won't pay for it yet! I am praying I will be one of the few exceptions, as the total self pay cost is $10,400 and I don't have that kind of money just lying around right now. I'll let you all know how it goes!

Susan,
Do you know that your stoma is too big? Is that why you're seeing this surgeon? If so, how did you find out.
Just wondering.

About 2 years ago after the birth of my 3rd child I was trying everything to lose weight and was getting nowhere and was hungry all the time so I went back to a bariatric surgeon(not the one that did my RNY because I moved out of state)and he ended up using and endoscope to check things out and said I had some mild stretching of both my pouch and stoma. Since they will never shrink again the only way to fix it was a revision which meant opening me back up again. That was not something I wanted to do so I gave up and started eating like the old fat version of myself, until a month ago when I found this site and the 5dpt. I am forcing myself to follow the rules but I get hungry a lot faster than I should and it makes it hard to stay the course...I have lost 12 pounds in one month but the first 8 were due to the 5dpt so 4 pounds in 3 weeks is a lot less than I was hoping for!

Thanks Doug!