You reminded me of one of my tips I have given over the years...If it sounds right.

Post op...Since you are sip sip sipping away.  Before you go to bed put 1oz of protein shake (with milk) on your nightstand (small Dixie Cup).  If you've been sipping, you may need to pee during the middle of the night.  After you go to the bathroom, drink (slowly) your 1oz of liquid.  It helps with both the protein and the liquid...During almost the last time you would think to get in your protein.  Change cups every evening!!...So the product doesn't go bad.  Leaving milk out for about 5 hours should not hurt you.  If you feel uncomfortable about that then whey protein isolate (in water) may have a longer life...Just an idea.  Brian

I'll throw out some general advise in no special order.  "In the hospital" there is a lot of hurry up and wait...You have to be flexible there.  You're not going anywhere...So if the surgery before you takes extra time you may be waiting an extra hour or so.  Then they may hurry you into the room.  So things can go real slow...Then go real fast...Be flexible.  You probably won't get good sleep in the hospital.  They wake you up at all hours to take vital...Blood pressure, draw blood for lab test.  Also try not to be put near the nurses station...They talk all night long!  You'll need to use pillows in different ways the first few weeks to get comfortable to sleep.  You may not get good sleep till you get home.  The pain (post op) near your belly button is where they put the camera...That is why it hurts there.

At home...You probably won't be able to get in all your water and protein.  Your doctor knows this...Just try and do your best and you should be OK.  Ditto on the sip, walk, sleep, repeat.  It helps your body to heal.  Know what a stricture is.  About 5% of RNY patients get them.  You could be that unlucky one in twenty.  Just be aware...Look it up.  They are very treatable...An out patient procedure.  When in doubt...Call your doctor.  Better safe than sorry.  Many people don't want to bother the surgeon...But if you need to call about something...Call!  Men lose the weight fast than women in general...We have a larger muscle structure so the weight comes off faster.

If you try one food and it doesn't sit well (example lean beef)...Don't eat it for several months.  Then try it again (at home) and see if the pouch is OK with it.  When you try new foods...Chew them well and do it at home.  YOUR POUCH RULES!!  YOU DON'T!!  When you try something new (basically say)  OK pouch...Here is something new.  Tell me what you think of it.  So you try the new food...Chewed well (small amount).  The you wait 5-10 minutes...See if the pouch likes it.  It will let you know.  If it feels strange down in your pouch do not proceed!!  DO NOT PASS GO...DO NOT COLLECT $200.  Your pouch may reject the food.  If you throw it up, it is almost like a baby spit up.  You wait awhile and be patient before you proceed to drinking water, shake, or even another food.

If you eat too fast your pouch will let you know...Either spit up or you'll get the foamies.  Know what the foamies are.  You may stand in front of a sink or use a cup and spit and spit a white foam while your pouch tries to settle down.  If you have eaten too fast or too much your nose may run or you get the hiccups.  STOP EATING.  Do not eat or drink anything for about 20 minutes.  That is the way for your pouch to let you know it "truly can not eat another bite"...Listen to it!!

Know the difference between simple carbs and complex carbs.  When you go to more complex cabs try and stay with them as long as you can...Till you've hit your goal weigh (assuming you are doing this for your health).  Simple carbs are addicting and stop your weigh loss in it's tracks.  I hit my goal and was starting to feel pretty good about myself...So I tried sugar...Say "I didn't dump".  So I go back to sugar, and Pepsi and cake, and candy, and before you know it...I've regained 30 pounds!!  Be wise and know your enemy.  Those at the local support group who are years out and are at or near normal weight have 2 things in common.  They have found some form of exercise that works for them...And they mostly stay away from many simple carbs.

Buy or borrow used clothing from friends, neighbors, and family.  You will go through sizes of clothing real fast.  One way to break a stall is to go out and buy about $300. worth of new clothing...Then your weight will drop quickly and you'll be out of those sizes within weeks.  I could go on and on...These are a few ideas that may help.  Brian

I'm back!!  Had to work and exercise.  How can I say these things without sounding "puffed up"?  Years ago I was asked by OH to be a "Friends of OH"...I chose not to.  If you look at the "Friends of OH" their posts are pretty common sense and rational.  Also I do watch what I eat...Not great, but average post op.  Just saw my labs at the doctor's on Tuesday.  Total cholesterol 123, triglycerides 68, LDL 65...Just saying I'm not a nut!!  Last night I was on Xanax...Late at night.  I was just sharing everything I heard.  I should have put some "caveats" (that is why my posts take so long...Spelling), saying I didn't agree with much of what was said at the meeting.  Sorry I won't read your sources till after I write.  I would have to copy and paste or lose my writing. 

Meloxicam...I thought it was strange to hear.  The PA did not refute what the bariatric surgeon was doing...She couldn't since she must send everything through the surgeon.  PAs and NPs have to walk a very fine line to only practice medicine under their doctor.  She was also there for support and to see what was going on...and gather information.  She was not the guest speaker.  So concerning NSAIDs I (we) have know for years what they can do to the remnant (that word "remnant" took 10 minutes to find...Google used the word "remaining"...But doctors use remnant) stomach.  I was as shocked as everyone else at the meeting.  But maybe this person was in such pain (RA or other pain) that putting them on a low dose and monitoring their progress made sense.  Concerning "NEVER WITH NSAIDS" is just wrong.  I take a 81 mg aspirin for my heart daily (doctor's orders).  I have also gone against doctor's orders and taken an ibuprofen, 1 per day when I have a very bad pulled muscle...Again, that is just me.  I am not recommending this for other people.  When I do this, I can feel it effecting the lining of my remnant stomach.  The (for me) the reward out weights the risk.  Again I would take 1 per day for just a couple of days to reduce inflammation.  Again we don't know why the surgeon prescribed Meloxicam, but it was done...And I'm sure for a good reason.  Again over 10 years and this was the first time I had heard this...I thought it should be shared...Just me.

Hemp Hearts  I was wrong on this one.  I was just writing words on a paper, not really taking notes.  The nutritionist recommend them for keeping a person regular.  It is an OK source of protein and other properties.  But she was stressing the benefit of movement of the bowels.  My bad.  It's was just something new I heard.

Shrinking the pouch  This was the first time I had heard of this.  We know there are procedures out there (ROSE and others) that make the pouch smaller.  But again someone mentioned it, and my ears perked up.  In my post I asked for any evidence, but none came forward, so I will disregard unless new studies show up.

I don't remember if it was the PA or the nutritionist who talked about the carbs + protein.  But still for me, it makes sense when you think about it.  If you take (examples) whey protein isolate by itself you blood sugar level would (will) drop not rise greatly (if at all).  If you eat fruit (by itself), you sugar level will spike, but then quickly drop.  But say you ate pinto or kidney beans.  You have protein, fiber, and carbs.  Your sugar level would remain fairly stable.  I believe this is true.  So in general protein + good carbs should keep a persons blood sugar level up for quite awhile.  That is all that was said.  Basic common sense I think.

Carbonation  I believe the jury is still out on this one.  Most WLS surgeon still (10 years out) have it in their "no no" list...Why?  There must be a reason?  What struck me was that it could effect the sleeve (banana/stomach) too it has been said.  Again, many or most surgeon say don't do it...Are they stupid??

Baseline bone density scan   Having a malabsorption surgery would seem to qualify for a need to at least have a baseline I would think.  Even if you had one done every other year, it might be good to have.  What someone else posted about the PTH Ionized Calcium Test (reading on the internet...Yeah scary), it seems you would have to lay off of calcium for several days to see how effective the test would be.  I think most PCPs wouldn't even know how long to lay off of calcium.  It would probably be a lab or orthopedic surgeon that would know that information.  But it could evaluate possible bone loss if done correctly.  I won't worry about it...I take my vitamins and my labs are good.

Peanuts   I agree...Just a small amount.  Other nuts (almonds/walnuts) are a much better choice for both good oils/fats and higher protein.  I keep our pantry full of different plain nuts and put them in my pockets to snack on.  I also put rye crackers (I get from IKEA), Cheerios, and raisins in my pockets to snack on also.  I do graze...No, it's not good, but it works for me.  

Two more things about the meeting (if anyone is still reading this).  There was a woman there who could not control her blood sugar...Real problem (RNY).  Every 2 hours she would have her phone go off to get some protein and carbs in.  She mostly would go with peanut crackers...Just saying this is what she did.  Almost daily she would become light headed...A major problem (I believe A1C not good at all).  She is considering major surgery.  She is looking to have the WLS surgeon convert her RNY into a sleeve.  Yes, I know is a gamble.  The remaining stomach must be useable.  I don't know how often the surgery has been done...But for those who have major problems and still are looking for the weight loss (for health) this is a path she may go down.

The last one was there was a man who had the sleeve and had issues with H pylori.  He had a hernia repaired and the flap from the hernia repair was infected with the scars from the H pylori...Hard to know what to do with that issue.  He has lost a ton of weight...Some not by his choosing.  Yes, he is on antibiotics...But they are not helping.  Feel really sorry for this guy. 

Well, this has been long...And again, I'm sorry I didn't just say "this is what I heard last night, take it with a grain (or ton) of salt.  But it was late, so I just quickly posted what I heard.  Later, Brian

Really good information.  I'll be 10 years out next month.  Most of the time (over the years) I know much of the issues.  Tonight we had both a nutritionist and a Physican's Assistant...Who has worked WLS for over 10 years.  I gained new information I'd like to share.  New things come out and we may not hear of them.  So here are a few items.  Some you may have already heard about...

One bariatric surgeon is prescribing Meloxicam (an NSAID)!!  It is for people who have very bad arthritis and can't be helped with other meds.  I looked it up and it wouldn't work for me (I have heart issues, including a heart bypass).  But for others it may be an option.

Hemp Hearts are a cool food for protein and keeping your blood sugar level up.  They also come in a powder form...It's more hemp like in rope...Not weed.

One person was talking about reshrinking the pouch.  She mentioned by going with a liquid diet for a certain amount of time (didn't here how long) the pouch can shrink.  Has anybody heard of this?  Is there any anecdotal evidence that this is true?? 

Another insight I gleaned tonight...Complex or even simple carbs (good fruit) plus protein will help keep your blood sugar level up for a long period of time (less crashing).  So mixing in some real fruit in your plain yogurt can and will go a long way for enjoyment and energy.

I knew carbonated drinks can enlarge the pouch.  I didn't know for the gastric sleeve, it can do the same thing!!

10 years ago I argued with my PCP...I told him I need a baseline bone density scan.  He said "you're a guy, you don't need one".  I told him I will be having malabsorption issues with this surgery.  I never got one done.  So I was talking to the PA tonight at the support group.  She said the doctor could run a PTH Ionized CA test...It could tell you if you (I) have issues with bone loss or not. 

One last thing...Dry roasted peanuts...Good or bad?  I've wondered about this one for years.  The nutritionist said just a handful a day.  She said too much oil and fat.  I always debated this one, since it's a legume.  She said "too much fat...I read the label, she was right.  Brian

The first 8 years of RNY I would have a 1-2 spoonful of Wendy's Chili for breakfast.  Just to make sure I got my protein in (beef, cheese [I put in myself], beans).  Now when I go to the coffee shop and don't like the soup of the day, I will get two poached eggs...Add a little salsa, salt and pepper.  I am turning 61 next month...Have medical issues for many years (heart, prostate, blood pressure, sleeping disorders).  So throughout the day I will take meds 8-10 times.  I will take it with milk or yogurt.  So that is my third choice for protein (and calcium that milk has in it).  Just some ideas...Brian

Just wondering what percent of people who go in for a VSG end up coming out with an RNY.  I know there are a few...It's like 1/4 of 1%, but it does happen.  If there is problems with the; anatomy, an ulcer, or birth defect, the surgeon (with prior approval from the patient...signed) will convert the surgery to an RNY.  Does anyone know the percent that has had this done?  I'm looking for hard cold facts...Documentation please.  Brian

Just decided to watch it on YouTube.  Good 1/2 hour made for TV short story...I use to read a lot of Ray Bradbury in my youth...

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c d=8&cad=rja&uact=8&ved=0ahUKEwj1u_CzhNPNAhVI62MKHYNjBFwQtwII QDAH&url=https%3A%2F%2Fvimeo.com%2F71483345&usg=AFQjCNFdTCB1 tyHSgot0d_O2UNdSSHH6wQ&sig2=bGekzOOek12ZB-pzeGpZ3Q

Giving two so there!!  The mental side of WLS is harder than the physical side.  Society will treat you different...Better in most cases.  If you're not grounded, it can really mess with your head.  The other thing (you being a guy) is that as your body releases fat through your liver (in the form of glycogen).  But what also gets released in your fat cells is estrogen!!!  Even if you have been stable for years you might feel like you are falling apart...And not knowing why??  It's the estrogen dump that is happening.  It will level out over the months...But for men who have never gone through it...It can mess with your head.  Brian

I more than anyone on this site "preaches" Wendy's Chili.  But, you need to be careful as a new post op.  The easiest proteins to digest for the first few months are; chicken, turkey, tuna, egg, whey protein isolate, milk, yogurt, beans, peas.  Later...Maybe a month or two you can "try...At home" things like beef, shrimp, and nuts.  Hopefully the nuts are plain and chewed to a puree...Same with the beef.  You may need a sip of water so they don't get the nuts stuck down your throat.  Once you have your first taste of beef WAIT 5-10 minutes.  Say to your pouch..."pouch here is something new...Do you like it"??  He or she will let you know soon enough.  Take it easy on the beef...It is harder to digest than the other meats.  The hardest meats to digest are pork, deer, and bear.  I would wait 6 months before trying any of those...Always at home (if you have issues...Dumping).

But for me...Once I found I could handle beef I found Wendy's Chili.  I would add my own cheese to mine...I still do (cheaper).  I add one package of crackers (not good for new post ops).  With beef you may have problems at one or two months.  You stop eating it for a few months...Then say at 6 months, you go back and try it a little.  Your pouch may accept it or reject it.  Each person is different.  Same with pork.  I can eat pork, but it doesn't sit well with me.  Almost like pre op eating too much Chinese food...How you've eaten it...But it isn't sitting well in your stomach.  You will find different foods just will not sit well...So you avoid them.  I can really taste fat post op in meats. 

But for me...A non cook, Wendy's Chili is what I had for breakfast for about the first 5 years...Just one spoonful.  I would then eat other really good foods for breakfast (like cooked spinach or vegetables)...In case I tested and cheated later in the day.  At least my breakfast was good.  Brian

I put this up last year...Repost...Sip sip sip post op!!

Just a repeat warning I like to give out.  Dehydration is the #1 reason post WLS people reenter the hospital...Know the signs and be careful out there...

Dehydration in Adults Overview

Dehydration is a condition that occurs when the loss of body fluids, mostly water, exceeds the amount that is taken in. With dehydration, more water is moving out of our cells and then out of our bodies than the amount of water we take in through drinking.

We lose water every day in the form of water vapor in the breath we exhale and as water in our sweat, urine, and stool. Along with the water, small amounts of salts are also lost.

When we lose too much water, our bodies may become out of balance or dehydrated. Severe dehydration can lead to death.

Causes of Dehydration in Adults

Many conditions may cause rapid and continued fluid losses and lead to dehydration:
 

• Fever, heat exposure, and too much exercise
   
• Vomiting, diarrhea, and increased urination due to infection
   
• Diseases such as diabetes
   
• The inability to seek appropriate water and food (as in the case of an infant or disabled person)
   
• An impaired ability to drink (for instance someone in a coma or on a respirator or a sick infant who cannot suck on a bottle)
   
• No access to safe drinking water
   
• Significant injuries to skin, such as burns or mouth sores, or severe skin diseases or infections (water is lost through the damaged skin)

Symptoms of Dehydration in Adults

The signs and symptoms of dehydration range from minor to severe and include:

• Increased thirst
• Dry mouth and swollen tongue
• Weakness
• Dizziness
• Palpitations (feeling that the heart is jumping or pounding)
• Confusion
• Sluggishness fainting
• Fainting
• Inability to sweat
• Decreased urine output

Urine color may indicate dehydration. If urine is concentrated and deeply yellow or amber, you may be dehydrated.

When to Seek Medical Care

Call your doctor if the dehydrated person experiences any of the following:

• Increased or constant vomiting for more than a day
   
• Fever over 101°F
   
• Diarrhea for more than 2 days
   
• Weight loss
   
• Decreased urine production
   
• Confusion
   
• Weakness

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cabin111
on 5/11/12 12:19 pm RNY on 10/09/06 with Antonio Coirin Also another reminder...Ketosis.  Bye the way I am not a doctor...Seek their advice on this stuff...Not the standard "well I read it on OH so it must be true".  When you are in rapid weightloss your body will probably go into ketosis.  You might want to look that up.  Your urine will be dark yellow, you will have a lighter fluid taste in your mouth ( Acetone).  Don't confuse ketosis with dehydration.  Ketosis is normal for rapid weightloss...Not good, but normal.  Dehydration is not... Top Reply More

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poet_kelly
on 5/11/12 12:25 pm - OH RNY on 11/04/08 with Lisa Martin Hawver Good info. 

Don't forget the pinch test.  The pinch test is when you gently pinch up a bit of skin on the back of your arm.  If you're not dehydrated, it snaps back to its normal position as soon as you let go.  If you're dehydrated, it'll stay in that pinched up shape for a couple seconds.  It's called "skin tenting."

          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.

DX was/is a college professor at a major university.  About 11 years ago he had RNY...And had complication.  The surgery was pretty new at that time.  He spent about 6 months in the hospital...So he read and read and read everything he could get his hands on concerning WLS and the RNY...You see the results!!

The below is written by DX...As many of you oldtimers know he was a very wise man...you can see by his post.  He doesn't come on these boards much anymore, but for me, as a new post op, his posts were priceless.  I've often thought he should make a CD of his posts and sell them.  He has hundreds of posts like these...Brian

DUMPING SYNDROME DEFINED,
EXPLAINED,
AND AVOIDABLE!

Ok arkman asked for a description
Of Dumping and here goes-

It's a combo of What I've been told,
What I've experienced and
Some of the Med-Speak Crap
and some from handouts from my Doc. At Support group.

(Remember, If you opt for DS or the Band
No dumping "per sea," But, often
Some lactose intolerance and minor dumping
Even with the DS.)

The weight loss that is achieved through the RNY
Appears to be greatly dependent
On the removal of the Pyloric Valve, (the "sphincter" of the stomach)
Leaving the individual with a small stoma
(see "Foamies" in another thread.) As the only regulator
Of food movement into the small intestine.
This results in the phenomena called "Dumping Syndrome."
It can cause an individual to feel sick or even faint.
And by "sick," I mean anything from -
"I feel a little icky..." to "Please God, Let Me Die!!!"
Although many think the name would come from
"Taking a Dump" just with the Volume turned WAY UP!
The Slang term actually comes from the way food is "dumped"
Into the duodenum or the jejunum moments after eating,
Rather than being released gradually in small amounts
By the Pyloric Valve from the stomach into the small bowel.

This Rapid gastric emptying, or dumping syndrome,
Happens when the lower end of the small intestine (jejunum)
Fills too quickly with undigested food from the stomach.
Now this is the part
That leads to so much confusion-
There is -
"Early Dumping"
And "Late Stage Dumping"
They are rather different.
And caused by different things.

"Early" dumping begins during
Or right after a meal.
Symptoms of early dumping may include -
Nausea, Vomiting, (resulting from that nausea)
Bloating, (Fast Gas Production)
And Diarrhea, (ranging from mild to Frightening)
And shortness of breath.

It is caused by -
"the high osmolarity of simple carbohydrates in the bowel."
*Brain running in back room to look for Biology Text Book*
Remember "Osmosis"?
That Permeable Membrane stuff?
Osmolarity is the "Come Hither" quality of osmosis.
Things with High Osmolarity have a lot of molecules and
"Suck" water To themselves.
The various types of sugar all have small molecules,
So that a gram of (for example) sucrose has MANY
More molecules than a gram of protein,
Creating a higher concentration
From simple sugars than from other foods.
They "Suck" More Water.
Still follow?
This matters because, inside the body,
Fluid shifts will generally go Toward
The higher concentration of molecules.

So, a bite of milk chocolate (lots of sugar),
When it gets to the Roux limb it will quickly "suck"
A lot of fluid into the bowel.
This rapid filling of the small bowel causes it to be stretched
(Which causes cramping pain).
With fluid from all throughout your body,
Rushing to "The Party in your intestines,"
Blood pressure can drop, you can feel suddenly
In the full blown effects of dehydration, etc...
I feel warm all over very quickly
Like I've had a Big Double shot of Brandy.
Flush face and cheeks and hot inside.
This also "Can Cause"
The activation of hormonal (depending on the person)
And nerve responses
That cause the heart to race (palpitations)
And "Can Cause"
The individual to become clammy and sweaty.
Vomiting or diarrhea may follow
(Diarrhea is most common)
As the intestine tries to
Quickly rid itself of this "irritant. "
The same sort of reaction
That you would have to Food Poisoning!
"Everybody OUT!!"
You typically have between 5 and 15
Minutes before It hits.
Later than that, could just be plain Ole Runs.

This Diarrhea "Can" Range from-
"Wow, I've really got to Go!"
To-
Rip the porcelain off the Bowl,
Explosive, "This is like 'From the Exorcist' Crapping!!!"

That best describes Mine.
Well, actually coupled with Late as well.
Some people have both types to a degree.
I'm lucky that way....

"Late Stage Dumping"
Happens 1 to 3 hours After eating.
Symptoms of late dumping include weakness,
Sweating, and dizziness.
Late dumping has to do with the blood sugar level.
The small bowel is very effective in absorbing sugar,
So that the rapid absorption of a relatively small
Amount of sugar can cause the glucose level in the blood
To "spike" upward.
The pancreas responds to this glucose challenge
By "cranking up" its output of insulin.
Unfortunately, the sugar that started the whole cycle
Was such a small amount that it does not sustain
The increase in blood glucose,
Which tends to fall back down at about the time
The insulin surge really gets going.
Yes?
So you feel like
Someone has given you an unnecessary
Shot of insulin.

It's basically a bout of hypoglycemia (low blood sugar),
Which causes you to feel weak,
Super Sleepy, and completely fatigued.
Late Dumping has another Evil in its arsenal.
It is a way for gastric bypass patients
To Fall into a vicious cycle of eating.

If the patient takes in sugar
Or a food that is closely related to sugar
(simple carbohydrates like rice, pasta, potatoes)
They will experience a small degree of Hypoglycemia
In the hour or two after eating.
The hypoglycemia stimulates appetite,
You eat more, cycle repeats,.....
And it's easy to see where that is going....
Yes?
Some, who claim "bingeing" with Carbs
Have actually been riding like a surfer
On a wave of hypoglycemia.
That requires some bravery and stupidity
In just the right balance, but does happen.
That "Emotional Eating," Thing is a doozey!

The reason that sugar does not cause dumping
In non-operated people is that the stomach,
Pancreas, and liver work together to prepare nutrients
(Or sugar) before they reach the small intestine for absorption.
The stomach serves as a reservoir that releases food
Downstream only at a controlled rate, through the Pyloric Valve.
This avoids the sudden large influxes of sugar
That can occur after a Roux En Y.
The released food is also mixed with stomach acid,
Bile, and pancreatic juice to control the chemical makeup
Of the stuff that goes downstream
And avoid all of these effects above.

For Late Dumping -
Lying down immediately after eating reduces the symptoms
Because gravity isn't draining the stuff straight into
Your intestines. Yes?
It may give you just a serious nap.

Now,
One more Intricacy that makes it so
Difficult to pin down -
"Dumping Syndrome-Do I have it or Not?"
Is-
Lactose Intolerance.
The symptoms of this are typically
Gas, medium to extreme,
Diarrhea, medium to extreme,
And most all of the symptoms of dumping syndrome
Except the Blood Sugar drop
Seen in Late Dumping.
Since Bypassing some of the small intestine,
(That portion where typically the milk sugar Lactose
Would be processed,)
The milk sugars may also create small
Amounts of Dumping syndrome on their own.
Many Bypass patients who do not have the big reaction to
Sugar in the form of Dumping Syndrome will
Experience the typical Lactose intolerance symptoms
That some Non- Bypass people have.
The Lactose in milk, has been eaten or processed
By bacteria mostly in Yogurts, and Cheeses
Which is why those don't cause problems.

Some will also have Dumping-Like Symptoms resulting from
Foods with high fat content.
More like severe indigestion with diarrhea rather
Than full out Dumping.
This is due to not mixing with bile
Soon enough in the system.
This is one of the reasons
For the 38% mal-absorption of Fats in RNY people
And the 81% mal-absorption of Fats in DS people.
In Both, the extra unabsorbed fats tend to cause them to
Poop like a goose!
So for both, particularly
The RNY folks who still get calories from a lot of that fat,
Best To keep those fat percentages down to keep
The Poo Normal. Yes?

Sugar Alcohol is another confusion in the mix...
Sugar Alcohols have a Laxative effect and can cause cramping
and bloating for anyone, WlS post-o*****n-Op,
even when eaten in moderate doses.
This cramping / diarrhea effect of one bite too much of
a Sugar Alcohol would happen even without the surgery,
But since many Post-Ops are seeking out more SF alternatives,
They end up being the folks who "test out" more Sugar-Alcohols.
(so not Dumping, just the Laxative property of Sugar Alcohol...)
 
Many, (me included)
Consider dumping syndrome
To be a beneficial effect of gastric bypass.
It provides quick and reliable negative feedback
For intake of the "wrong" foods.
In practice, most patients DO NOT
Experience full-blown dumping
More than once or twice.
Most simply say that they have
"Lost their Taste" for sweets.

Some, have Dumping Syndrome early on,
But as their system adapts to the new
"Goings On," they lose it,
And their Digestive system compensates.
Others, like me, have it for life.

There are some people who have had no reaction
To sugars and then One Day- POW!
Full Blown Dump!
Something about the food they ate,
And the speed that in went into
The intestines, set them off.
This happens sometimes
Due to drinking with a high osmolarity food.

Speed into the Intestine
Plus
Molecular Density Of the thing entering,
Equals "Degree of Dumping Syndrome Effect."

Now,
All that sounds bad.
But, It can all be avoided-
JUST DON'T EAT SWEETS!
AND HIGH CARB/SWEET MIX FOODS!
Or-
The General Guidelines
For avoiding/reducing Dumping Syndrome
(From a handout at my support group
From a Nutritionist who works with Bypass folk.)

1.) Avoid taking liquids with meals.
Liquids should be taken 30 minutes before or after meals
And limited to ½ to 1 cup servings.
Carbonated beverages are not recommended
In the initial stages of the diet to prevent excess gas formation.

2.) Small, frequent feeding should be provided.
The number of feedings depends on the patient's tolerance
To specific portions of food.
Foods should be eaten slowly and chewed well.
Avoid those known to cause individual problems.

3.) The diet should be low in simple carbohydrates,
High in complex carbohydrates and protein,
And moderate in fat
With the purpose of achieving and maintaining
The optimal weight and nutritional status of the patient.

4.) All food and drink should be moderate in temperature.
Some patients tolerate warm water
Better than iced or cold water.

5.) Avoid foods that are natural laxatives,
Such as figs, prunes, and licorice.

6.) If "dumping" is a problem,
It may be helpful to lie down
20 to 30 minutes after meals and even up to an hour
To retard transit to the small bowel.

7.) Slowly introduce small amounts of milk into the diet
To determine tolerance.
If milk products are tolerated,
They can play a key role
In providing an easily tolerated protein
And other nutrients such as calcium and vitamin D.

Trick/Tip from my Doc- (useful for Diabetics as well)
Pectin,
A dietary fiber found in fruits and vegetables,
May be helpful for treating dumping syndrome
And even simple diarrhea.
Pectin delays gastric emptying,
Slows carbohydrate absorption,
And reduces the glycemic response.
1 tsp pectin powder 3 times daily may be effective.
(It's that "Sure-Jell" stuff for making
Home-made Jelly. Great food additive)

So,
That's the -
"Everything and then some I know about Dumping."

Best Wishes-
Dx 

It's egg whites I believe.  Here is the nut on the back...Click on Supplemental Facts section for protein and stuff...

http://www.jayrobb.com/protein/egg-white-protein-vanilla.asp #tab2