Help! Can anyone help me understand?

I'm cross posting this, because I'm not sure where it belongs but... I had my surgery almost four years ago in November.  I never reached my goal weight - going from my highest weight (367/346 day of surgery) to lowest (237/243 plateau) and never going down anymore.  Within the last 10 months, I started gaining again and am up to 270.   So I went back to my doctor and he ordered an upper GI for me.   Apparently, my pouch is still quite small, but it empties ridiculously fast.  The radiologist was like - "It's empty already, I can barely get the pictures - keep drinking."  They gave me the crystals and the gas made my pouch hurt horribly, but it passed into my intestines very fast and caused belching that cleared it.  By the time I left after drinking 16+ oz of barium solution and another 10 oz of water afterwards - my little pouch was still empty and I was getting hungry. That being the case - shouldn't I be LOSING weight if nothing is staying in my tummy? If things are basically dropping straight into my intestines and being flushed away, I'd think I'd be losing weight - not gaining. Could this also explain my extreme anemia and exhaustion? Can anyone explain the science?  I know the final report hasn't been given to Dr. Halmi yet, but I don't know what solution he can offer if my pouch is still small.  I also don't know what I'll do if I keep gaining weight / being hungry all the time.

I'm certainly not a doctor (or medically inclined)....but I think I can explain ONE possible reason for this because this was my situation too.   (However, for all you science-types, feel free to correct me if I'm wrong)

As I understand it, the stomache is really basically only a holding container for food.   A normal stomache also mixes in enzymes and other stuff to partially break down the food (which doesn't happen in the stomache after many types of WLS).  There is no absorption in the stomache.  The food is slowly released into the intestines where it can finally be broken down and absorbed by the body.   Another important role of the stomache is that when it slightly stretches, it sends a signal to the brain that you are full.

If you dump food into your intestines quickly, your stomache won't expand (and you won't get a "full" signal).  But ALL food will be processed by the intestines so you still get the nutrients AND CALORIES.

The STOMA is the hole connecting the stomache pouch to the intestines.  In many cases this becomes enlarged (or is made too large to begin with).  So, you can eat too much food even with a tiny stomache pouch.

One potential solution (although VERY new so it has no long term data) is the Stomaphyx procedure (and several other even newer transoral procedures).  With Stomaphyx (pronounced Stoma FIX) the surgeon uses an endoscope device down your throat to reduce the size of the stoma by a series of pleats.   The doctor may also use the same device to pleat your pouch to make it smaller too.   It is believed that this will allow a person to retain food in their pouch longer thus feeling full sooner and help with additional weight loss.

And, personally, I hope it works.   I had this procedure last week but I really won't feel the effects for the better part of a month until I return to solid foods.

Hope this helps, Lorri

Your story is just like mine. I was hungry right after eating. It was awful. I had the lap band added to keep the food in my small pouch and now I am doing much better. I have hope again, have lost all the weight I regained and now I am on my way to losing the rest of my weight.  Find a good revision surgeon and you are on your way. Good luck.

it sounds very much like me when I needed a revision.  Stoma enlargement was what caused my emptying out.

Hi, just like many of you I too have had gastric bypass surgery in 1999.  I lost over 130lbs and have regained about 25lbs over the course of 2008.  My weight loss was great in the beginning and thru since the surgery I had no complications and while I never reached my ideal weight goal I've joined the guy  which has help some what but I know I need help with portion control.  I remember eating less than my 1year old child after my surgery and now I am still not able to eat an entire meal all at once but I am eating all the time.  I just learned about stomachx surgery and wondered if any one has had it and can shed some more light on this subject.  Or can provide any great surgeons who does this type of reconstructive surgery in the Massachusetts area.