Malnutrition = feeding tube!?!??!

I think I'm a little confused here. They are saying you can't get the water in because the pouch is the same size as right after surgery? I was able to drink a 16 oz bottle of water in 20-30 mins the week after surgery. the pouch is basically a funnel. The only thing that should make tha****er back up and not flow out of the funnel (pouch) would be something at the stoma wouldn't it? Perhaps a stricture? scar tissue? something blocking it? If not I don't see how the water could back up. If the doctor couldn't answer that question for me I believe I would be seeking another opinion either from another bariatric surgeon or a gastro doc who has experience with bariatric patients.

Next question is if you are drinking a shake and eating 5 mini meals what size are the meals? if the meal is protein which I would assume it would be if you are struggling to get in your protein even if you ate 1 oz of meat at each mini meal you'd be getting in 35g of protein add that to your shake with 49g and you are getting over your required amount of protein could you cut back to the shake plus 3 mini meals of 1 oz of meat to be over your 64g of protein allowing you more time to drink? Just trying to help you think it through. So you'd get up and 3 hours later finish your shake so you'd already be at 49g of protein and 16 oz of fluid. Then if you could sip an oz every 5 min. that would give you another 12 oz bringing it up to 28 oz, repeat that for the next hour and you'd already be up to 40 oz of water. Wait and have your first mini meal, wait the 30 mins and then because you've had food perhaps do one oz every 10 min for the next hour bringing you up to 46 oz then go back to every 5 min and you'd be at 58 oz already and you wouldn't even be at your second mini meal and be about 8 hours into your day? And seriously if you can't get a one oz cup and drink it every 5 mins without it coming up I'd go sit in the doctor's office until he could explain why, that is NOT normal regardless of your pouch being the same size as surgery. And in case he doesn't believe you (some surgeons have a God complex and don't believe what they hear) I'd sit there with a bottle of water and my one oz cup and prove what is going on!

I'm sorry, but I must not be reading something correctly, or am just confused. When you say your pouch is the same size as the day of surgery, do you mean before the surgery, or after? Is it too small, or too large? Your post is saying that you are malnourished, but at 2 1/2 years after surgery, and with a considerable amount of weight left to lose, I think you are eating and getting more nutrition than you think you are. Maybe not enough protein, but certainly more than enough calories. Nothing that would require a feeding tube.

I hope you can clear some of this up, but it seems some of the others are confused like I am.

I couldn't stay hydrated post-surgery and did end up having parenteral nutrition. It absolutely was not a fun experience, but I can tell you now that you can get as much as you need. I was told to focus on the liquid intake first (with protein being the preferred method), a minimum of 64 oz daily before I even thought about eating. Once I put the focus on my liquid intake and quit worrying about what food I should eat and how much, everything fell into place. I was worrying too much about food and not enough about liquids. I now get easily 80 oz each day and more most days. Which considering that pre-op, I rarely finished a single 32oz cup of sweet tea (!) in an entire day, is a major improvement in my entire life, let alone for surgery! It has made a big difference to be getting enough fluid. Makes much about life better, including what I want to eat, when I think I feel hungry (or not), whether I need something sweet, etc, etc. So that is my advice. Focus on getting the liquids in first and worry about those meals only after that liquid goal has been achieved.

As Kelly has already pointed out, what your surgeon is telling you is wrong (or you misunderstood what (s)he was saying), because we don't absorb nutrients in our pouch (just as we didn't absorb them in our natural stomach... that is he job of your intestines.  Always has been, always will be.  So washing food out of the pouch will NOT prevent you from absorbing nutrients.

How do you know that your pouch is the same size as right after surgery?  have you has an EGD done?  If not, since you are able to drink that little fluid, you need to ask for an EGD to see if you have a stricture or something else preventing you from drinking normally because the amount you are drinking is even less than most new post-ops.

Lora