sleeve stretching

[caroline 0]

Hi,

I was sleeved last Tuesday, so I am new to this site. I have been reading articles online and I am just worried that my sleeve is going to stretch. Does anyone know the probability of a sleeve stretching?

Thanks,

Caroline

[Bama 0]

I was sleeved on 8/12/09 and have worries about the same thing. Not that it is a strong probability, but just a concern.

I ask my surgeon about this and he said, yes, I could do that if I ate til I was overly full on a regular basis. Just as we stretched our tummies prior to surgery, we could stretch it again, although I don't believe to the same degree.

[MacMadame 81]

My surgeon says it's very hard to do. The part of the stomach that remains is made of a very tough muscle and it just doesn't stretch the easily.

There was a study where they measured the size of people's sleeves once they were two years out from surgery and only 1 person had any change in size. They were still maintaining just fine, too.

[cajun 46]

Although stretching does not seem to occur, a person who decides to "eat around" the sleeve can gain all their weight back just by eating softies all day every day.... so we have to be dedicated to a life long change of eating patterns that will help us Live Well! The support of friends on forums like this can help when the going gets rough. Some people may need a 12 step program or professional help if they find they are not taking care of themselves...but it sounds like most of the folks I meet on forums are dedicated to doing the job, and are successful.

[Oregon Rose 2]

The only study on "sleeve stretching" I've read is "Evaluation of the Radiological Gastric Capacity and Evolution of the BMI 2-3 Years After Sleeve Gastrecotmy," Obesity Surgery, May 2009, Braghetto, et. al.

This study comes from the University of Chile. Operative procedure was the same as that of Drs. Jossart and Cirangle and most physicians in Spain. A 32 French bougie was used as a calibration tube and division of the stomach began 2cm from the pylorus. Measurements were taken on 15 patients at three different intervals for this study.

After the the sleeve had been formed and the bougie had been pulled out mean gastric volume was 70 ml. (Volume determined using methylene blue.)

Gastric capacity was measured on the third postoperative day by both Barium Swallow and CAT scan. The mean was 108 ml by Barium Swallow and 116 ml by CAT scan. (The difference between the intraoperative measurement and this measurement is probably due to decreased swelling as the stomach healed.)

The same 15 patients were measured again 24-36 months after VSG. Mean stomach volume was 250 ml by Barium Swallow and 254 ml by CAT scan.

During the study period, BMI decreased progressively and then remained stable at BMI=25 in 12 of the 15 patients. The other 3 patients had a slight increase in BMI (of worst of which was BMI=30 per their chart.)

So, this study indicates some normal stretching of the stomach will occur.

What are the lessons to take away from this article:

1. Work really hard to lose weight while your stomach is as small as possible because it will be harder later.

2. We've all been told to avoid carbonated beverages and to only eat until full - not until stuffed. This is because carbonation and overeating can stretch your stomach more than will naturally occur.

3. Even with the natural stretching that will occur, we can still maintain a healthy BMI. Think about it - 250 ml is about 1 cup. Before surgery your stomach held about 7 cups. If you restrict the number of meals you have and don't graze you won't be able to eat the same number of calories you ate before surgery. The key is DON'T GRAZE.

When doctors say the sleeve won't stretch, you have to ask them how many Barium Swallows and or CAT Scans have they done over the sleeve life of their patients. There is a difference between what a doctor has observed with one patient (who may have needed a Barium Swallow several years after surgery due to some problem) and a controlled study such as that done at the University of Chile. Doctors have very strong opinions about things and they don't always have the same opinion. I'll stick to what has been scientifically demonstrated.

Well, hopefully this info should stimulate some lively discussion.

Edited September 3, 2009 by Oregon Rose

[cajun 46]

This is a very interesting article, thanks for sharing it. I sounds like the surgery will continue to help us maintain a healthy weight as long as we don't eat softies constantly all day long.

I look forward to seeing more research long term.

[carolyn24seven 11]

how many Dr.do a barium swallow follow up after 2 years? not many if any i bet. they just go off of what studies are done by Universities. They are also selling this surgery, so they are only going to tell about the positives. The sleeve will only help us get to a healthy lifestyle. my never to be humble opinion.

[Headhunter 0]

It would seem prudent to me to request a Barium Swallow after a couple of years, to see exactly where you are "at". Even though there is no indication of difficulty, when I hit my two-year mark (I had a bypass), I'm going to have a number of tests done (at my expense) just for comparison to numerous tests done a couple of months after my surgery.

The whole "stretching" issue (for all of the various WLS surgeries) is quite interesting.

HH

[Oregondaisy 2,021]

Believe me, if you overeat, you will be so uncomfortable, you will learn to not do it again. You will learn by seeing the food on the plate, whether it's too much to eat.

I am sure my sleeve has stretched some, because right after surgery, I could only eat 3-5 bites of anything. But I don't think it has stretched more than it is supposed to.

I can eat more now, but not very much more. It really depends on what you are eating.

[MacMadame 81]

You don't have to have a barium swallow. Just do the cottage cheese test. It's faster and cheaper. It's also more to the point... it's about what *you* can put in without feeling bad, not how much barium can fit in there. :001_tongue:

Also, there are studies being down on sleeve dilation as patients get farther out. All this stuff gets studied. They also track total loss and regain. Some surgeons do it more informally and some publish their results.

But, regardless of studies, the part of the stomach remaining is not the stretchy part. It's extremely hard to stretch out. There is some relaxation of the tissues over time, but it's limited. It's just like the difference between latex and linen. Sure, my linen suit stretches out when I wear it, but I can't make it stretch out 3x its original size like I can with my latex gloves.

[carolyn24seven 11]

the cottage cheese test? when would you do this after a month and then again after each year? seems like it is not going to stretch that much. Sleeve seems like it is still going to be a useful tool in keeping the weight off if I try at all.

[MacMadame 81]

Bariatric Resource Center: A4 The Cottage cheese Test, BSCI Articles, A4

It's really easy to do. You can do it anytime you want to know how big your stomach is. I did it around 7 months because a lot of people were doing it and we wanted to compare. I may do it again tomorrow on my one year surgery anniversary.

[Malaika 50]

Bariatric Resource Center: A4 The Cottage cheese Test, BSCI Articles, A4

It's really easy to do. You can do it anytime you want to know how big your stomach is. I did it around 7 months because a lot of people were doing it and we wanted to compare. I may do it again tomorrow on my one year surgery anniversary.

WOW MAC - 1 year - HAPPY SURGAVERSARY! Is it amazing how far you've come? From what I've read, I think you've done awesome!

[MacMadame 81]

Thanks. :001_tt2:

[AJW 18]

What is the cottage cheese test may I ask?