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Can Your Stomach Pouch Stretch After Bariatric Surgery?

One of the most common questions in the field of bariatrics is asking, “can your stomach pouch stretch after bariatric surgery?” Patients want to understand what they can expect regarding stomach size long-term after a gastric bypass, gastric sleeve, or duodenal switch. 

Despite height and weight, almost all adults have the same stomach size. Before weight loss, your stomach is about 12 inches long and 6 inches wide, holding about a quart of food when expanded. After bariatric surgery, the pouch is about the size of an egg, holding ~1 ounce of food at a given time. 

Stomach Pouch Stretch After Bariatric Surgery

There are many rumors within the bariatric community that you can stretch your stomach pouch after bariatric surgery. Regardless of whether or not you have had weight loss surgery, your stomach is designed to accommodate a certain amount of stretching, which is a normal part of the digestive process. 

Naturally, you will experience your stomach stretch after weight loss surgery. This stretching will not deform your new pouch or sleeve by changing shape or size in a way that we can’t work with the patient to restore. 

After eating a standard meal, your stomach will expand for a short time before digesting the food. Long term, with the gastric bypass or gastric sleeve, the same process is happening. Yet the trouble comes when you train your stomach to accommodate more food. 

Think of someone who participates in a hot dog eating contest—they can eat 80 or so hot dogs in one sitting. They don’t have a different stomach size; they have just trained their stomach to stretch and not complain the same way an average individual’s stomach would. 

What to do if Your Stomach Pouch Stretches

Over time, it is possible for your stomach pouch to stretch after bariatric surgery and to train it not to complain when you eat more than the recommended 4 to 6 ounces of food per meal. Your stomach is just doing the job you ask it to do—accommodating more food. Yet it will not become chronically deformed. 

In gastric sleeve patients, we remove about 70% of the original stomach. Similarly, for gastric bypass patients, their new pouch will be about 20 to 30 milliliters in size compared to the original stomach, which was about 1 quart in size. 

So no, your stomach pouch can not and will not stretch back to the size it once was before weight loss surgery. Instead, it is more about what the stomach learns to accommodate without complaining. 

It is possible to retrain the capacity at which your stomach pouch stretches after bariatric surgery. This process will involve eating smaller portion sizes and picking good satiety-level foods. The best way to avoid weight regain after bariatric surgery is to eat lots of protein and veggies while avoiding carbs such as bread, rice, pasta, and potatoes.

If you are worried about whether the stomach pouch stretch after bariatric surgery will cause you to gain weight, or you are concerned you are overeating, we recommend you come into our office to talk with a surgeon. Follow-up is a critical part of long-term success in a bariatric journey. Seeking advice from your bariatric providers once the problem arises will save you from potential issues.