Stoma Vs. Sleeve. Stretching

Is the stoma that is left after RNY more likely to stretch than the Sleeve?

They both can stretch, but needs to stretch some over time, and the other only causes problems if it does. 

My sleeve was 3cc when new, and I could only take a bite or two till full. That kind of restrictions gets the weight off quickly, but I need to eat protein now to maintain, and that kind of restriction would be a drag. I can now eat a smallish, normal meal. A small / normal stomach is what I need to maintain.

A stoma on the other hand, can cause problems when it stretches, like reactive hypoglycemia and weight gain. There have been procedures that they hope will help fix and retighten a stoma (stomaphyx, rose, etc) but none of them have shown any promise beyond the pre-op diet. I would not allow a surgery on me that replaced my pyloric valve with a manmade stoma.

Stoma size has nothing to do with RH.  The rapid change in blood sugar usually happens 2-3 hours after eating (sometimes a bit sooner) when the meal is completely in the intestine.  So it doesn't matter whether it took 30 minutes with a normal stoma or only 15 minutes with a stretched stoma to ass from the pouch to the intestine.

Lora

Not technically true.  There are times, especially when you drink after eatiing (even if you wait a half hour), that the sugars get into the intestines so quickly that the crash is nearly immediate.  My blood sugar can drop anywhere from half hour to two hours after I eat, but it's generally a lot faster than 2-3 hours.  Of course, since I've learned to control my diet, I don't experience this much at all anymore.

Appreciate it thank you

I know what you are getting at, but it's really hard to give you an answer because you are comparing two things that have almost nothing in common.  If your sleeve is made to be tight in the first place, the "stretch" is the normal healing process and you will eventually eat about four times what you could eat originally.  For me, this means that I can eat between 4-6 ounces of food at a time.  That's it.  My stomach no longer has much of the stretchy part left.  Think about it like you would think about thick leather.  It can stretch, but not indefinitely and not very much.  The part of the stomach that is left after VSG is similar.  Yes, there is a bit of a stretch but not much.  If more of the fundus is left, there is more stomach to stretch out.  This is why the photo that goes around with the pens is so misleading.  The size difference after surgery is much less important than the eventual difference in capacity later in maintenance.  Now think about the stoma.  It can stretch and this allows all the food you eat to go right into your small intestine.  It is like having a sink without a stopper.  Often, the smaller intestine can stretch to fit even more food.  You can see the problem.  There is nothing to be done to correct this problem. 

It is more appropriate to compare pouch stretching to sleeve stretching.  The stoma is an entirely different "creature".  The pouch and sleeve are stomach muscle while the stoma is simply intestinal tissue and staples/stitches, so the stoma is much more likely to stretch than the pouch or sleeve.

Lora

This is where I put my head in the oven 

But really. I am having a really hard time justifying RNY if it is just as likely to be stretched as VSG. Sure I sound ignorant but my head is spinning today. 

The stoma is always open, unlike the pylorus, the stomach's normal emptying port. In a normal stomach, the pylorus opens and closes, allowing small boluses (boli?) of food to pass into the small intestine. This is why normal people rarely dump. (Although anyone CAN, and only about 30% of RNYers do on a regular basis.) So, even if your Sleeve stretches---and it will, I promise (more on this later) you will still have some restriction because your Sleeve will still get full. If your stoma stretches too much, food will not stay in the pouch, so you can eat a LOT, and you'll get hungry much too soon. Currently, there just aren't any really good ways of repairing a stretched stoma. There is a new procedure called the Apollo Overstitch, but it hasn't been around long enough for there to be much data.

Now, about the Sleeve stretching. IT WILL, but for most people it still remains small enough to give good restriction. If it didn't stretch some, you'd not be able to eat enough in the long term. The Sleeve is made from the least stretchy part of the stomach, but still sometimes it stretches too much. It is possible to do a re-Sleeve, but this is a riskier operation than a 'virgin' Sleeve.

The Sleeve is the stomach portion of the DS. In the past few years, we've seen some Sleevers adding the Switch to their Sleeve because they either didn't lose enough, or are struggling with regain. This is a fairly easy, straightforward revision. We've also seen people revising their RNY to the DS for the same reason, but this is NOT an easy procedure, and there are very few surgeons who do it.

I should also add that the horror stories people come on to post are intimidating. Not enough to change my resolve, but enough to make me want to really make sure I pick the surgery I want for the long haul of life.