Pyloric Valve

 I ran across a thread in a DS forum talking about the loss of the pyloric valve and long term weight loss with RNY.  I take it with  grain of salt (because it's on a DS forum), and i found most forums the people are very adament about thier procedure versus others.  But,  I would like smarter people here to chime in if they have experience/information on the subject.  The link posted wasn't very clear to me, so I am posting it here to read.  

http://www.lenoxhillhospital.org/press_releases.aspx?id=2106
 

It would help me feel better about choosing this procedure.  Thanks.
 

Honestly, most of us stay far away from the "surgery wars" they really are not worth the time.

 Not interested in the wars wither, but my question about long-term weight loss without the valve is still valid.  

I'm not sure what information you're asking for.  Do you have specific questions about the pyloric valve?

The pyloric valve is between the stomach and small intestine in "normal" digestive systems.  When you eat food, it stays in your stomach a while and your stomach mushes it up and there are gastric juices in there that help break food down.  After a while, the valve opens and lets the food go into the small intestine a little at a time.  Soon after all the food leaves your stomach, you'll start to feel hungry again.

After RNY, you no longer have a pyloric valve.  There is just a small opening between your pouch and small intestine.  That's why they advise us not to drink with meals.  If you eat some food and then take a drink, the liquid will wash the food right out of your pouch.  Soon after your pouch gets empty, you'll feel hungry again.  Runny foods, like yogurt for example, don't stay in your pouch too long either.  Solid food will stay in longer and keep you feeling full longer.

The site you linked to is also talking about reactive hypoglycemia, which just means that a while after you eat, your blood sugar drops too low.  That can make you feel sick.  That site was saying that reactive hypoglycemia is a problem when RNY folks eat a lot of simple carbs (like crackers, for example) because the crackers get into the small intestine too fast because there is no pyloric valve.  If you eat protein with all your meals, though, and don't eat a lot of simple carbs, that probably won't be an issue for you.

Although it should not surprise anyone that people with RNY (and therefore without the pyloric valve) have much more trouble with glucose levels than those with DS or VSG, my problem with this article is that it does not explain the leap from "While many patients... could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production." to "I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss".  He does NOT show a link between RH/dumping and weight gain!

Lora

 Thanks for the info.  That's what i was looking for.