I was reading this today and found it very interesting. I have to admit I do sip while eating and generally drink about 15 - 20 min after, but I am going to make a conscious effort to stop! Hope you find this helpful.

It's kind of long, but definitely worth the read.


Why we don't drink with meals.......

Sometimes understanding WHY we have to do something (or not do something) helps us follow the rules. Here's the low-down:

Before surgery you had the pyloric valve at the bottom of your stomach to keep food in the stomach while is began the digestive process. As food was digested and ready enough to be released into the intestine, the pyloric valve (a trap door really) would open and let a small amount of food out of the stomach and into the intestines. Digestion would continue, the trap door woud open and a bit more food would be released. And on and on... This process can take 2 to 3 hours in a normal stomach.

AFTER RNY we have to mimic this action manually and the only way to keep food in our pouch (which is basically a funnel now with no trap door) we have to eat dense foods and not mix it with liquid. The denser the food, the longer it can stay in the pouch. Food can stay in your pouch for up to 1.5 to 2 hours if you don't drink water. The minute you add water (or any liquid) to the mix, you are creating a "soup" that will quickly empty out of your pouch.

About 40% of the digestive enzymes our food needs to be broken down is contained in our saliva. Our pouch does not produce gastric acid anymore, so the salive enzymes are all we have to work with here... Which is another reason why need to chew, chew, chew really well. Once food gets to the pouch, those digestive enzymes go to work on the food to begin breaking it down (mostly carbohydrates). Our pouch doesn't churn as much as our old stomach used to, but there is still some movement with that well-chewed food. The longer it stays in the pouch, the more it is broken down and prepared for the intestines to do their work of grabbing nutrients from the food. If we wash the food out too quickly, the intestines can not absorb the nutrients from the food we eat because it passes too quickly undigested. (This can also increase the risk of constipation and intestinal blockage.)


Of course with your pouch being empty you'll get hungry sooner. For new post-ops, this isn't necessarily a big issue because the hunger hasn't returned. But for those further out from surgery, the hunger can be ravenous and you want to keep food in that pouch for as long as possible. That's why it's recommended that the further out you are from surgery, the longer you wait to begin drinking after meals (60-90 minutes).

SO... besides all that, there's the risk of stretching the stoma (the opening between the pouch and intestines). If you have dense food that has not begun to be digested in the pouch and you drink water you are FORCING that dense food to be pushed through the stoma prematurely. That opening is only about the size of a ladies index finger, but if you push food through the opening before its ready to go, you'll eventually stretch that opening. This is FAR more worrisome than stretching your pouch. Once it's stretched it can become the same diameter as the pouch itself... essentially creating one big long tube that food can be packed into at meals. Basically a 20-foot long stomach.

This caution from surgeons is NOT a scare tactic. This is about biology and medical science. You have to manually do the work of the pyloric valve now that you don't have one. And it's about preparing your food so your body has the best chance of absorbing the vital nutrients it needs for survival.