When can I......
only when you get too thin and wanted to gain weight. so practically - never.
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
http://voices.yahoo.com/the-rny-rules-no-drinking-meals-3160 813.html?cat=5
The rule is: No drinking with meals or for 30 to 60 minutes after each meal. But why??
After roux-en-Y gastric bypass surgery we are given the rule of not eating with meals or for 30 to 60 minutes after a meal. It is an important rule, but do you understand why it is so important? "The RNY Rules" attempts to help you understand the reasoning behind specific rules set up by nutritionist and bariatric surgeons.
Before gastric bypass surgery you had the pyloric valve at the bottom of your stomach to keep food inside the stomach while it began the digestive process. As food was digested and ready enough to be released into the intestine, the pyloric valve (a trap door, really) would open and let a small amount of food out of the stomach and into the small intestine. Digestion would continue in the stomach, the trap door would open and a bit more food would be released. And on and on... This process can take 2 to 3 hours in a normal stomach.
After RNY gastric bypass surgery the pyloric valve is no longer part of the newly formed stomach pouch. It remains at the bottom of the stomach which is bypasses.... So we don't ever use the pylorus again.
With our new pouch we have to mimic the action of the pyloric valve manually and the only way to keep food in our pouch (which is basically a funnel now, with no trap door) we have to eat dense foods and not mix that food with liquid. The denser the food, the longer it can stay in the pouch. Food can stay in your pouch for up to 1.5 to 2 hours if you don't drink water. The minute you add water (or any liquid) to the mix, you are creating a "soup" that will quickly empty out of your pouch.
About 40% of the digestive enzymes our food needs to be broken down is contained in our saliva. Our pouch does not produce gastric acid (or hydrochloric acid) anymore, so the saliva enzymes are all we have to work with here... Which is another reason why need to chew, chew, chew really well. Once food gets to the pouch, those digestive enzymes go to work on the food to begin breaking it down (mostly carbohydrates). Our pouch doesn't churn as much as our old stomach used to, but there is still some movement with that well-chewed food. The longer it stays in the pouch, the more it is broken down and prepared for the intestines to do their work of grabbing nutrients from the food. If we wash the food out too quickly, the intestines can not as easily absorb the nutrients from the food we eat because it passes too quickly undigested. (This can also increase the risk of constipation and intestinal blockage.)
Of course with your pouch being empty you'll get hungry sooner. For new post-op gastric bypass patients, this isn't necessarily a big issue because the hunger hasn't returned yet. But for those further out from surgery, the hunger can be ravenous and you want to keep food in that pouch for as long as possible. That's why it's recommended that the further out you are from surgery, the longer you wait to begin drinking after meals (60-90 minutes).
SO... besides all that, there's the risk of stretching the stoma (the opening between the pouch and intestines). If you have dense food that has not begun to be digested in the pouch and you drink water you are FORCING that dense food to be pushed through the stoma prematurely. That opening is only about the size of a lady's index finger, but if you push food through the opening before it's ready to go, you'll eventually stretch that opening. This is FAR more worrisome than stretching your pouch. Once it's stretched it can become the same diameter as the pouch itself... essentially creating one big long tube that food can be packed into at meals. Basically a 20-foot long stomach.
This caution from surgeons is NOT a scare tactic or some random rule made up to torture gastric bypass patients. This is about biology and medical science. You now must manually do the work of the pyloric valve because you don't have one. And it's about preparing your food so your body has the best chance of absorbing the vital nutrients it needs for survival.
Since my RNY gastric bypass surgery almost 18 months ago, this is the one golden rule that I have follow with extreme dedication. I've lost 113 pounds and hunger is not a major issue for me. I truly believe this is a rule that I can easily follow for the rest of my life and because I understand the science behind the rule, I'm more willing to make it a priority.
Pam Tremble
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
