Loss of restriction from VSG to bypass

[Bella1506 1]

Hey, I have had a rxy bypass 2 weeks ago and I was on liquids for one week and puree now. I have felt no restriction even with Water I am gulping a glass down easily and having puree very easy with no pain or restriction.
I have tried eggs and a few other little things because I freaked out with no restriction. Can I have people please help with their own story about this… does the restriction comeback?? Has anyone spoken to their surgeon as to why they lost it??? Any information and support would be appreciated I have been really low and upset about this worrying I’ll never feel full again

[SleeveToBypass2023 2,650]

I'm interested in this since I just found out I have to have a revision from sleeve to bypass. It kind of worries me, so I'm interested to see what people say.

[Dan1131 20]

I’m 3 weeks post op on the same VSG ago RYN Bypass and I’m wondering the same thing. I too have had no feelings of restriction but I’ve also been super careful and kept my intake to 1/2-3/4 cup of full liquids. Just this week they added cottage cheese, ricotta, runny oatmeal and apple sauce. Next week is purée. I have been doing 3/4 cup cottage at 3 table spoons in 10min intervals and had no issues. I’ll admit I’ve tasted an olive size piece of cheese or veg here and there this week and had no issues. I tend to think unless I stuffed myself I wouldn’t feel restriction but I’m so freaked out about rupturing my pouch that I’m being super careful. Bottom line: 3 weeks out and I don’t feel any different than I did 10 years after my VSG, except no more GERD!!!

[SleeverSk 635]

2 hours ago, SleeveDiva2022 said:

I'm interested in this since I just found out I have to have a revision from sleeve to bypass. It kind of worries me, so I'm interested to see what people say.

Oh, can I ask how come? You seemed to be doing so well

[The Greater Fool 2,054]

Fluids and purees go straight through the pouch, which is why most people are put on liquids and/or purees. Your pouch is healing and it's a way not to stress everything.

You won't really notice your level of restriction until you get to actual chewable food.

Good Luck,

Tek

[SleeveToBypass2023 2,650]

6 hours ago, SleeverSk said:

Oh, can I ask how come? You seemed to be doing so well

I have gastritis and GERD, plus I had to have several biopsies because my stomach is full of different kinds of polyps. I have to have 3 more endoscopies to remove them all. I was told I have to have a revision to bypass because the polyps are coming from the gerd and gastritis. So once all the polyps are removed, then we go in and do the bypass.

[SleeverSk 635]

9 minutes ago, SleeveDiva2022 said:

I have gastritis and GERD, plus I had to have several biopsies because my stomach is full of different kinds of polyps. I have to have 3 more endoscopies to remove them all. I was told I have to have a revision to bypass because the polyps are coming from the gerd and gastritis. So once all the polyps are removed, then we go in and do the bypass.

Thank you for sharing, the reason I ask is last

[SleeverSk 635]

Sorry, I don't know what going on with my tablet every time I choose quote to reply the text highlights blue and I can type anymore. The reason I asked was last year I had a contrast ct scan done which showed a mass the radiologist wanted further investigation but my surgeon and gp both agree it was just scar tissue from the sleeve. I also had polyps before surgery. I think I will go back and ask for further investigation just to be safe. Thank you for sharing SleeveDiva2022

[SleeveToBypass2023 2,650]

1 hour ago, SleeverSk said:

Sorry, I don't know what going on with my tablet every time I choose quote to reply the text highlights blue and I can type anymore. The reason I asked was last year I had a contrast ct scan done which showed a mass the radiologist wanted further investigation but my surgeon and gp both agree it was just scar tissue from the sleeve. I also had polyps before surgery. I think I will go back and ask for further investigation just to be safe. Thank you for sharing SleeveDiva2022

Of course!! The concerning thing was that I had no polyps at all before or right after surgery. Something happened in 8 1/2 months to cause this. And the gastritis and GERD became off the charts in the last 6 months, so I was told once all the polyps are gone (I have a few different kinds of polyps) then I'll go in for my revision.

[Starwarsandcupcakes 2,070]

The restrictions will come when your onto more substantial foods. I had the same thing after my revision happen.

[catwoman7 11,220]

yes - like others have said, you normally won't feel the restrictions until you move to solid food. Liquids and purees go right through you.

[Pouchify 10]

I just had a revision from Lapband to RYN on January 10th. My surgeon told me I wouldn’t get restriction from the revision. I have to really focus on weighing and measuring my food intake so I don’t gain weight. He said people who had restrictions from their previous surgery do not feel the restriction. I measure my food and I can only tell when the food hits my intestines and I feel full there in my lower belly.

[ryan_86 335]

I'm close to 5 weeks post-revision from sleeve to bypass, and I noticed the same thing. The doctor told me it's normal.

Here's my explanation for what's going on:

1. The place where a normal stomach meets the intestine is called the pyloric valve. The stomach churns to further break down food, the valve opens to let food pass into the intestine. We (meaning sleevers) had a small stomach, and because the valve was still present and behaving normally with a sleeve, we felt restriction, meaning the valve didn't open more frequently just because the stomach was smaller.
2. With bypass, the valve is removed (technically it's bypassed since they leave it in along with the first 30cm or so of the intestine). The connection between the pouch and intestine is called a stoma, and liquids and purees will move right through it because it's not a valve/it's open all the time. In my experience, it's possible to drink/eat purees too fast so that they don't drain through the stoma quickly enough, but you're right, it takes some special effort to do that.
3. Restriction is a bigger factor when you get to solids, which I did this week. If you eat too much too fast, it just sits in the pouch. Think about a sink that drains slowly because there's junk in the pipes; that's the same principle - too much stuff trying to move through a too-small pipe. The pouch doesn't churn food up like a stomach to make its passage easier. If the solid you too big/too much/too dry/too fast, it sits and feels very heavy, your body starts producing mucus to lubricate the passage of the food through the stoma (this is what people call "the foamies"), and if that doesn't do the trick, that food is coming back up. I had that lovely experience with ground turkey and thus learned that while I was told to chew thoroughly with my sleeve, I could ignore that advice. Not so with a pouch; when they say chew until it's a paste, you have to.

So restriction does become a greater factor when you proceed to solids. It really does force you to slow down, eat small bites, chew VERY thoroughly. Like with sleeve, I imagine it's still possible to overeat if you graze, so it also still takes some discipline to make smart food choices, pay attention to when you're satisfied, and be deliberate with how long a meal is.

Also bear in mind that bypass is not just a restrictive procedure. It's malabsorptive as well.

Good luck!

[Chel1 104]

@ryan_86 Thanks so much for this. I was not going to do the revision from sleeve to bypass due to all the posts of people mentioning that there was no restriction with the bypass. I am terrified of regaining weight. I had my sleeve done in 2017 and had regained about 30 pounds back during the last 3 years due to a serious back injury in 2020 during COVID. I also have been having some Water retention this past year. Even with this I am still down 103lbs from my original weight.

My GERD is out of control...I had the Upper GI and the EGD with Bravo recently...my Bravo tested acid at 50 when per doc it should be below 15. When they told me to go back on my meds during the test the numbers dropped and they uped my meds from 20mg to now 40mg per day. I go back in to meet with the surgeon soon.

Although I am now back in the gym and eat considerably well/healthy...my portion sizes are still small too I would love relief from GERD and the higher probability of health issues with my esophagus later. However with the scare folks are putting in the forums about no restriction I would rather live with GERD than to not have this tool to help me stay on track.

Your post helped to relieve "some" of my concerns. Please let me know how you continue to do on your path. You can send a DM if you like to stay in touch. I woukld love to know your progress and how you're doing with the malabsorption.

[Muwins 5]

On 1/28/2023 at 9:11 AM, Pouchify said:

I just had a revision from Lapband to RYN on January 10th. My surgeon told me I wouldn’t get restriction from the revision. I have to really focus on weighing and measuring my food intake so I don’t gain weight. He said people who had restrictions from their previous surgery do not feel the restriction. I measure my food and I can only tell when the food hits my intestines and I feel full there in my lower belly.

Thank you very much, Ryan, for the complete and thorough response.