Can you stretch your stomach

First topic message reminder :

Hi All,

I have read almost every post on here the past couple of weeks and posted myself and received some valuable feedback. Now I am concerned though. Different topics have postings that talk about stretching your stomach out so fast by eating quickly or drinking too much water. I know we have all had different surgeons but I am worried that some give the impression that it's so easy to stretch it out. Is that true? Can anyone give some feedback that their doctors have told them so that I know? Thank you.

Would have replied earlier but missed this thread somehow. Anyway sleeve size change has been studied the abstract below is the results

Quote :

Evaluation of the radiological gastric capacity and evolution of the BMI 2-3 years after sleeve gastrectomy.

Braghetto I, Cortes C, Herquiñigo D, Csendes P, Rojas A, Mushle M, Korn O, Valladares H, Csendes A, Maria Burgos A, Papapietro K.

Department of Surgery, University Hospital, University of Chile, Santos Dumont 999, Santiago, Chile. ibraghet@edclinicauchile.cl
Abstract

BACKGROUND: Sleeve gastrectomy is a restrictive procedure for treatment of obese patients with different body mass index (BMI) and presents good results in terms of a reduction of percentage of excess weight loss and BMI. There is no consensus which is the optimal technique regarding to the diameter of the gastric tube, but a capacity of 100-120 ml has been suggested. In this prospective study, we compare the gastric capacity evaluated with barium sulfate or computer-aided tomography (CAT) scan early and 24 months after operation compared to the changes in body weight and BMI reduction in a small group of 15 consecutive patients submitted to sleeve gastrectomy. METHODS: Fifteen successive obese patients submitted to laparoscopic sleeve gastrectomy were included. They were studied in order to measure the residual gastric capacity with barium sulfate and CAT scan early (3 days) and late (2 years) after surgery. RESULTS: The early postoperative gastric volume was 108 +/- 25 ml (80-120 ml) and 116.2 +/- 78.24 assessed with barium sulfate and CAT scan, respectively. The gastric capacity at the late control increased to 250 +/- 85 and 254 +/- 56.8 assessed with the same techniques. However, patients remained stable with a BMI close to 25 without regain of weight at least at the time of observation. CONCLUSIONS: Gastric capacity can increase late after sleeve gastrectomy even after performing a narrow gastric tubulization. It is very important to measure objectively residual gastric volume after sleeve gastrectomy and its eventual increase in order to determine the late clinical results and to indicate eventual strategy for retreatment.

my surgeon said the same thing in regard to the 10% regain. And also that yes, the sleeve can stretch but NOT to it's previous capacity. It makes sence to me that the sleeve can stretch but not regrow. So allthough bigger than the original sleeve, not as big as full stomach capacity.

I do not think I worded something quiet right there. What I meant was I would avoid a surgeon who was reluctant to sleeve or trying to talk you into another wls by saying i do not do or prefer not to do a sleeve because they stretch and or they lose to much weight. I agree it would be a very foolish surgeon not to say a sleeve may stretch. there to me tho is a world of difference between that and actively pushing another surgery by slamming the sleeve either though his own incompetence or inability to do them well. I would avoid them like the plauge.

I also belive the skill of your surgeon plays a BIG role in how successful your surgery is.

I have to add that I do NOT judge success of the surgery on what weight is lost. I see the sleeve as a tool, a tool that limits the volume of food you can put in it at any given time to approx 250ml. if that is what the tool does it is succesful. what YOU choose to put in that tool is YOUR choice. the results you get will depend on what you choose to put in that 250ml

So far as in watching all those on the forum and others both online and in real life all who have claimed weight gain still had a perfectly working sleeve they where snacking. I am saying this again as I know people fear the big evil stretch but the here and now around us people it is snacking that has to be watched closely.

applesauce

My surgeron told me from the lowest weight you get to you will have a regain amount of app 10% back after that. If you choose to east icecream all the time,drink coke etc then you will put on weight but if you eat properly then you wont.

Again the stomach can be stretched, yes it has less stretch in it than pre-sleeving however you would be a fool to think a body part can't stretch out...especially the stomach.

shelly25 wrote:

...but I'm still glad i went for the sleeve and not the band!

Oh Yeah!!!!

I'd like to see awareness of the sleeve increased in the medical community. I know they may not have long term data on the sleeve like they do on the band and the bypass operations but I'm still suprised by the amount of GP's who have "never heard of the sleeve".

I wish they'd do more stories on the positives of all the WLS's available including the sleeve on shows like Today Tonight and Current Affair instead of just running negative pieces.

Knowledge is power and more choices and options.

it will be interesting to see statistics further down the track when researches have gathered longer term results.Its such a variable isnt it,our bodies,minds etc are all different, then like sohpia said sleeve size etc and what we do ourselves as in eating wisely etc.
but m still glad i went for the sleeve and not the band!

My surgeon did say to me "The sleeve can be resleeved" - that was feedback though from Sleeve Surgeons in other states who had obviously done just that (performed a resleeving), as I was my surgeon's 12th sleeve pt and he wasn't suggesting that I needed to be resleeved by him !!!!

I think what is quite tricky is any research re stretching sleeves is that it will take years to hit some kind of a peer reviewed literature medical journal - due to the number of Sleeves they would have to measure and compare before they had meaningful results. All we have ti then is ancedotal word of mouth stuff.

Also, no one is talking much about a) what stomach capacity the surgeon was aiming for in the first place b) bougie size when operating which surely would have some bearing on the final result. I remember reading about lower success rates in France, but the bougie size was a lot larger comparably (? 50)

Also, from my reading, a 10% late regain is quite "normal" in any sucessful bariatric surgery.

Regards
Sophia

Yep I agree there Carrie. I believe that sleeves can stretch, augigi is correct in that anatomically it just makes sense.
However, I don't necessarily see this as a bad thing. I think that at some stage people need to have a bit of self responsibility kick in, and use the sleeve like the tool it's meant to be, not the perfect final word in effortless weight loss surgery.

Well said Shelly & Mapmar...

Now, back to those dastedley stretching sleeves.
All I know at this stage is I HOPE with all my heart that my sleeve doesn't stretch. And on the off chance that it may be a possibility I am going to try to keep treating my new little tummy with the respect it deserves after all the lovely changes it is helping me make to my life.

Big love - Carrie

when i come to read a thread about a topic thats all i want to read about ,the topic
and like mapmar said be supportive or dont comment.
I didnt want to take away from the topic on here with my comment,but also dont want to read things that I find offensive or not supportive to members
shelly

This is a forum where people can write their own opinions/thoughts down. It is not a forum for people to argue and cause disruption. As the old saying goes “If you don’t have something nice to say, don’t say anything at all”….

If you feel a post is inappropriate please PM the moderator of that section for it to be reviewed.

Everyone will have different opinions on things, we are not all correct, are medical practitioners or surgeons and we do not all have the answers. We can advise the best we can in our own experiences of having the sleeve and what information has been provided to us by our own surgeon.

With this all said, I would kindly ask you all to refrain from being “nasty” to people on the forum and get on with being nice to one another and being helpful instead.

I saw Dr Michell's nurse for inital appt on Friday and she said (correctly) that they do not know many longterm results with the sleeve, and that there is a potential that over time the pouch may stretch and lead to weight regain.

The thing is, of course it's anatomically possible. They have to tell you the risks of surgery so you can make an informed decision, and this is a potential risk. But they don't have enough longterm data to know how much of a risk, in what % of sleeve recipients.

The person who said they wouldn't go near a surgeon who said the sleeve can stretch? Crazy. I wouldn't go near a surgeon who said it couldn't - OBVIOUSLY it potentially can and I feel the surgeon would be misleading or omitting information if they did not make the pt aware of that risk.

i had my sleeve done in Aug.08 have gone from 110kg to 75-74 my surgeon gave me a goal of 70kg while i gave myself a goal of 75kg. i have days where i have to remind myself how well i have done even tho i havnt reached my surgeons goal because i do wish i could get into a smaller size but . i have gone from size 22-24 to 14-16 normal shop size clothes so (yippee).
i worry about stretching because i am a grazer when i eat.but reading what Appple sauce has written reminds me of the reality of it. i cant eat even a fraction of what i used to 'pig out on'. i do have 'naughty food' but i believe in the have a tiny taste of anything as long as its tiny. i beleive that we are all afraid of putting it all back on but i think that the only way we could do that is to only eat and drink very high and i mean very high cal. food etc on a 'daily' basic. so not actually making the tummy bigger just consuming higher cals.
anyway sorry for the rambling just wanted to say something about how i feel
cheers
Sallyanne

Well said Carrie.


Sharon

You go there Shelly25 gurl!!!!!!!!!!

Shelly25,
Yes this forum is here for everyone to learn,get informed ,have a comment or just have a good read.
Get over the whole Miss thing i't so old!!!!!

sharon.

Re this stretching thread and perception of stretching

Are there any sleevers out there who've had "cheaty" moments with food? I mean eating a whole bag of Grain Waves or a whole choccy bar? I couldn't do this until about 6 months out (prob when my sleeve changed from its beginning size of 100ml to its fully grown up size of about 250ml) and then I thought oh no, my sleeve has "stretched" I've failed.

But when you get a chip and crush it up, I dissolves into dust so I figured out, oh yeah there probably isn't more than 250ml of chips in that packet, it just seems like a lot of food (as well as being non a nutritionally good choice & containing lots of calories..).

When I eat protein like grilled chicken and ham there is NO WAY I can fit more than 250ml in there so I know it hasn't stretched (as people know who have accurately checked this with the cottage cheese test etc etc) but I would believe that failure could be related to food choices (and the calories in those choices). The sleeve is a great tool, I could no longer eat like I used even if I wanted to but its still a mental journey to make better choices so I can get the right amount of nutrients from food. This is where chatting to a psychologist along your journey is handy in identifying why you eat - stress, tiredness, to 'reward yourself' etc and I would recommend it to anyone who had emotional eating issues pre-op (I did this by the way, it was a good choice).

I am a little concerned I could stretch my sleeve (to what? from 250ml to 300ml? still nothing on the 1L ice cream fests I used to pack away pre-op) but I know I've been given a second chance for a healthy life with this surgery so I'm a work in progress, trying to choose better foods.

Every day is a chance to make better choices. You only fail when you stop trying.
(thats me trying to be all Zen master and make good food choices lol..)

Apple
This thread has many different opinions on this and once again not a one answer question with lots of people having an opinion just as miss has the right to do so give her a break and lay off her.

Eeeughhh Mylanta instead of food gross!! I take a Somac every day since the op but I haven't had to take any Mylanta since I lost the weight and I don't miss it, yuk! Turned out I had a hiatus hernia removed so that explains that but being bigger can cause your stomach to poke up through your diaphragm and give you a hernia (the pressure from the food in there and the general extra weight you are carrying inside) so being sleeved has improved my health no end.

I think (only an opinion please don't kill me) that it probably possible for the sleeve to "stretch" a bit but please, have you seen the size that you are left with, you would have to be eating all day every day to get it to increase by even 50ml. I don't think it could ever get back to fitting a litre in, they remove 3/4 of your tummy. I read somewhere (internet or on here?) that you have 2 lines of titanium staples down one side of your tummy & the other side is the muscular side which doesn't have a lot of give in it so I don't think it's going to go anywhere.

I agree with Apple (except for the slapping bit, I leave that to Apple ha ha...) you can probably regain 5kg or so once you have finished your "dream run" down from size 20 plus or whatever you started with but really, if I stay 85 kg forever instead of 127kg I will keep doing a happy dance. I would even be happy to go back to 90kg and be a size 18 cuz they sell plenty of nice clothes in that size too (oh and did I say my health is heaps better now!!). It's all relative.
(happy to be where I am)

Peazles all 5 surgeons and one dietician i've seen have told me the sleeve could stretch. One surgeon said it was unlikely, but could happen, the others all said it could happen. One of those 5 surgeons was the head of the Obesity Surgery international conference or something along those lines and he had just got back from teaching the surgery in India. I did not go with him for the surgery as he refused to do the sleeve on me even after my lap band erosion as he clearly didn't believe in what he did for a living - he told me normal people lived without bands and so could I - diet and exercise - I didn't need a sleeve just some mylanta every time i felt hungry instead of food. This from a prominent international obesity surgeon that has done plenty of sleeves on this board and was recommended by several people on here. I hate 2 faced doctors. And there are plenty of incompetent surgeons operating in Australia, not sure who posted that there wern't that many but your mistaken, I have been butchered by several severe mistakes that i found out later were from known in the medical community incompetent surgeons that are still practising. You often find these people promoting themselves, banding or sleeving on TV. Stay away from TV doctors!! If they were that good they wouldn't need to advertise on TV the gps would give them more than enough referrals to fill their calendars.

Peazles wrote:

I know that quite a few people on this forum are of the opinion that a sleeve, if done correctly, cannot stretch. Can people please tell me if their surgeon has told them this specifically, or if they've just heard it 'somewhere'. Alternatively, could you please also post if your surgeon has told you that your sleeve can stretch.
If you've read a good, science based article that gives valid reasons as to why your sleeve cannot stretch, could you please point me in the direction of it, as I cannot find anything that tells me that a sleeve can't stretch.
Thanks so much.

aprilsun I have spoken to 2 people like that, who swear that you shouldnt have sleeves because they went from a size 8 to a 10. I look at them and just about want to slap them I think they are THAT stupid. One of them was a size 20 bfore the sleeve the other a size 22 and they class the sleeve a failure because they went from a size 8 to a 10. Neither one of them can eat close to 250ml neither one has put on even 5kg. Yet they slam the sleeve. Wonder why I want to slap em hey.

applesauce

miss the surgery has a failure rate and NOTHING you do can make it work, the sleeve is just done wrong, wrong size or wrong shape. As always you have been told this before, and your inability to grasp even the basics of this surgery is a concern. So is your inability to do as asked of you and post in your thread.

Libby yes I do think of it being a successful surgery, I can eat no more than 250ml at one sitting. I tho have a totaly stuffed medtabolisim and do NOT lose any weight unless eating under 600 calories a day. this is from years of yo yo dieting plus all the weight I have taken off prior to the sleeve. I also see it as a sucess as even tho I gain a few kg it has prevented me regaining all the weight I lost before surgery. I know it is not the size 10 dream of many, but for me the dream was to get mobile and to get out there and live life. The sleeve has done that for me and works perfectly as the tool it is meant to . My body just doesnt want to co operate and lose weight unless on a tiny amount. I can not blame the sleeve for that, or say the sleeve has failed.

I have said before you are going to see more people especially those who where well over 150kg or coming from a long stint with an unsucessful lapbandhaving sleeve surgery that is 100% succesful yet NOT getting close to goal because their metabolisim just can not handle it. I say these people in particular tho it can be others and of course some of those I listed will be fine. They just tend to be the ones with the most abused metebolisim. They will then be left with the choice to either accept what weight loss they get and just get on with life or look at having a DS which involves malabsoption and thus gets around the bad metebolisim. But with that surgery comes more risks and some pretty nasty side effects if you do not watch your diet very carefully.

For me right now I choose to just get on with my life, do a bit of optifast if I gain a bit to much, as in my mind it is a hill I have to climb to lose a bit of weight now not a moutain. If my health problems get worse later on down the track and feel further weight loss will help and the side effects will not out way the benifits I may look at a DS. But I wouldnt do it to make my ass look good in a size 10 pair of jeans.

applesauce

I havent been sleeved yet, so cant put in my experience yet, but a friend of mine had a sleeve done about 3 to 4yrs ago, and she lost a lot of weight...dont know exactly how much, but I nearly freaked out seeing her at a shopping centre one day............ she was skinny, her bones were all sticking out for everywhere. Then I didnt see her for a couple of years, and rang her one day to ask about the sleeve as I was looking into having it done.

She was not a happy lady.............said she had started putting weight on and was devastated, and told me not to go ahead a do it, cause the weight would just come back. Because i hadnt seen her in awhile I asked how much weight she had put on............ she didnt really say, but said that she had got done to a size 8 and that now all her clothes were too tight and she was needing to get bigger ones either 10 or 12.

My theory is that she got down to a weight that was too low for her, and couldnt maintain at that level, either she starved herself on the way down and now her body was not able to keep at that small amount of food and so she might have upped her quantity and was most probably at her ideal weight now......... I say this because she was quite a stocky sort of girl and I just couldnt imagine her a size 8.

I havent seen her so I cant say............ she's a friend that I dont see that often. She had rung her Dr at Mercy Bariatrics and he told her to go in and see him and that the cost of the visit was on him, I'm not sure if she said that he told her that the weight gain was something that could happen later down the track. I suppose I could ring her and find out what happpened, I just dont want her to think Im just ringing her to find out her business, because we are not close friends.
At the time she had her op I didnt know about the sleeve, I thought she had a band put in like me, it was only when I rang her last year that I found out she had the sleeve.
Anyway dont know if thats helpful or not, just thought I would post.

Anna