Kristen H.
POUCH RULES FOR DUMMIES (Abridged Version!)
RULES OF THE POUCH
1. The patient must time meals five (5) hours apart or the patient will get too hungry in between.
2. The patient needs to eat finely cut meat and raw or slightly cooked veggies with each meal.
3. The patient must eat the entire meal in 5-15 minutes. A 30-45 minute meal will cause failure.
4. No liquids for 1.5 to 2 hours after each meal.
5. After 1.5 to 2 hours, begin sipping water and over the next three hours slowly increase water intake.
6. Three hours after last meal, begin drinking copious amounts of water and other calorie-free fluids.
7. Fifteen minutes before the next meal, drink as much as possible as quickly as possible. This is called "water loading."
8. You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.
THREE PRINCIPLES FOR GAINING AND MAINTAINING SATIETY
1. Fill pouch full quickly at each meal.
2. Stay full by slowing the emptying of the pouch. (Eat solids. No liquids 15 minutes before and none until 1.5 hours after a meal).
3. Protein, protein, protein. Three meals a day. No high calorie liquids.
THE IDEAL MEAL FOR WEIGHT LOSS
The ideal meal is one that is made up of the following: 1/3 of your meal to be low fat protein, 1/3 of your meal low starch vegetables and 1/3 of your meal solid fruits. This type of meal will stay in your pouch a long time and is good for your health.
FLUID LOADING
Fluid loading is drinking water/liquids as quickly as possible to fill the pouch, which provides the feeling of fullness for about 15 to 25 minutes. The patient needs to drink about 80% of his/her maximum amount of liquid in 15 to 30 seconds. Then just take swallows until fullness is reached. The patient will quickly learn his/her maximum tolerance, which is usually between 8-12 ounces.
Fluid loading works because the roux limb of the intestine fills up, contracting and backing up any future food to come into the pouch. The pouch is very sensitive to this and the feeling of fullness will last much longer than the reality of how long the pouch was actually full.
EXERCISE
In addition to exercise helping to increase the weight loss, it is important for the patient to understand that exercise is a natural antidepressant and will help them from falling into a depression cycle. In addition, exercise revs up their metabolic rate during a time when their metabolism, after the shock of surgery, tends to want to slow down.
Original article written by: Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem Response To Phasic Gastric Distention. Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional Pouch Volume Following the Gastric Bypass Procedure. Ob Surg 1996; 6:38-43. "Dummies" version rewritten by Sally Perez.
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