The key to an easy recovery period after VBG surgery is to avoid overfilling the pouch and avoid vomiting, especially the first few days. There is one way to do this: measure twice, swallow once, and vomit never.
This weight loss surgery needs time to heal. Most weight loss surgeons require that you be on a pureed diet for the first six weeks after this bariatric surgery. Remember, in this operation the outlet is reinforced with a band (made of some plastic type material) and cannot stretch. As with any weight loss surgery, some swelling happens immediately post op, and this will make the pouch feel even tighter than normal.
A liquid diet for the first two weeks after this procedure is normal and will allow the VBG to heal. The stoma (opening between the stomachs) will swell a bit after this weight loss surgery. This means if you cheat and have some food—it might get stuck. If food becomes stuck, and serious vomiting occurs, you can disrupt the staple line, enlarge the pouch, and cause many problems. So, if your weight loss doctor wants you to be on a liquid diet—don’t cheat.
Avoid certain foods the first six weeks. These foods, if you eat them, will make you very uncomfortable. Some of them can get stuck in the stoma, and some will expand in the pouch and make you vomit. They might even rupture the staple line.
Foods to Avoid the First Six Weeks
Foods that will expand in the pouch and may make you uncomfortable:
- Breads, pastas, granola. Go lightly on oatmeal.
- Foods that can become stuck or cause bezoars (hair balls—here kitty)
- High fiber containing vegetables
- Pulp, cores, and seeds of fruits (avoid grapefruits, oranges, and bananas
Vertical Banded Gastroplasty (VBG) pouch rules
This weight loss surgery is designed to limit what you eat and make you feel full early. You can defeat the pouch, however. The way to defeat it is to drink when you eat, drink after you eat, or eat a lot of high carbohydrate foods (milkshakes, French fries, candy, and the like).
The pouch is a tool, and the tool has to be used if you are going to reach your weight loss goal. As with any tool, there are some simple rules:
- The pouch is designed to be full with a limited amount of food. Once you feel full stop eating.
- The pouch is designed to keep you feeling full for a long period. You can defeat this by washing food out of the pouch—so don’t drink for an hour after you have consumed food. Now, this rule has been modified a bit. It seems that some liquid with meals works well, and does not cause you to gain pounds. But the key is to sip those liquids, not gulp them or use the liquid to force down more food. The other key is to be very careful not to eat and drink at the same time during the first 12 weeks.
- If the pouch is empty, you can drink a lot of water or other liquids—but be smart—do not drink high calorie liquids. Water is the best thing you can drink. Skim milk, unsweetened fruit juices, broth, coffee, Crystal Lite®. Some weight loss surgeons feel that Nutrasweet® sweetened products stimulate appetite. Some have absolute prohibitions against carbonation. You should SIP six to eight cups of fluid between meals. This will serve to keep you hydrated.
- You should take a chewable multivitamin or a liquid vitamin daily. If you are a pre-menstrual female, then iron may be needed. Mineral supplements should be discussed with your weight loss surgeon or primary care doctor, depending upon your medical condition. Some weight loss surgeons state that because there is no “malabsorption” with this operation, that vitamins are unnecessary. The National Academy of Science recommends that all Americans should have vitamin supplementation. (If you are not from America, do it anyway.)
- Chew your food, but before you put the food in your mouth, make certain that it is cut smaller than your little fingernail. (No, false nails can be used as a measurement device.) If you do not chew your food, you will be very sorry.
- Eat slowly. A meal should take between 15 and 30 minutes. Less than that means you are eating too fast, more than that means you are grazing.
Items to eat the first few weeks:
- pureed meats
- cottage cheese (low fat)
- pureed peaches
- pureed yams or sweet potatoes
- cooked, soft-grained cereal
Eat three meals a day, and eat them at the same time each day.
- Purchase some smaller plates, forks, spoons, and use them for yourself and everyone else in the family (Your family members will benefit from smaller portions. Honest, they will).
- Food groups are meats, fruits, vegetables, and dairy. You should have a balanced meal with a bit from each category.
After three months the capacity of your VBG pouch will increase
…this is not unusual and is even expected. Typically, it will go from one ounce to four ounces. If it is larger than four ounces, this might indicate that the pouch has been overfed. You can do the cottage cheese test to see how large your pouch should be.
Items to eat after three months:
After three months, you should strive for a well-balanced meal. While a wide range of foods is open to you, you must remember the rules of the VBG:
- Do not eat and drink at the same time. If you do, then sip small amounts with your bites. Do not using the liquid to force unchewed food into your stomach.
- Chew your food to a semi-solid (pudding) consistency
- Measure twice, eat once, and vomit never.
- Do not skip meals, and do not substitute snacks for a meal
- If you snack, plan the snack, and make it a nutritious snack.
Also, you know you are full when:
- You feel full
- You feel nauseated
- There is pain in the back
- You are developing more GE reflux (heartburn)