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The Best Ways to Prevent Pouch Stretching Post WLS

Stomach Pouch After VSG

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Following weight loss surgery, it is crucial to follow the right kind of diet. Overeating causes weight gain and stretching of the new pouch, failing the purpose of the procedure.

Even though the stomach does not burst open upon overeating after bariatric surgery, it does make one feel nauseous and if it becomes a habit, causes the stomach pouch to stretch.

Normal Pouch Loosening

It is important to remember that after a gastric sleeve surgery, the pouch will loosen gradually over the next few months.

Initially, after surgery, the suture line (where the stomach was divided) is very tight. The gradual loosening that occurs is a good thing that will allow you to tolerate more food and a variety of foods.

Prevent Pouch Problems After Bariatric Procedures

Portion control after weight loss surgery is crucial if one wants to prevent excessive pouch stretching. Here are some general recommendations to follow after surgery.

  1. Avoid eating past the point of fullness. This is best accomplished by eating slowly at meals and taking no more than two bites per minute.
  2. Eat small bites. Think dime sized or smaller.
  3. Avoid drinking with meals. It is okay to have 1-2 sips (teaspoon size or less) if something is dry, but avoiding drinking copious amounts of liquids at meals. Observe the 30-minute drinking rule post-bariatric surgery to prevent discomfort.
  4. Avoid grazing between meals. Have three meals daily and 1-3 snacks depending on your hunger/fullness cues.
  5. Eat healthy food that nourishes the body, in controlled portions.

Shrinking the Stomach Pouch After Weight Loss Surgery

The stomach tends to stretch and contract as we eat. To reset one’s stomach pouch, there are two options.

  • Pouch Reset Diet – Here, one would need to severely restrict their food intake for a few days. This diet would include lots of fluid intake, and then slowly moving on to full liquid, pureed foods and eventually, a healthy diet (in small portions).
  • Revision Surgery – A patient can gain weight even after a particular bariatric procedure. The reasons could be- the loosening of the stomach pouch or severe post-op complications. Here, revision surgery is performed.1 For instance, in case gastric sleeve does not have the desired effect, it can be revised to a Duodenal Switch surgery.

Surgical factors like the expansion of the stomach pouch can be treated via revision surgery. Such a procedure has shown positive results about weight loss.2

Out of these two options, pouch reset by controlling eating habits is the less invasive way to go but requires way more willpower.


  1. Courtney Fulton, Caroline Sheppard, Daniel Birch et al. “A Comparison of Revisional and Primary Bariatric Surgery.” Canadian Journal of Surgery 2017; 60(3): 205-211
  2. Almantas Maleckas, Linas Venclauskas et al. “Weight Regain After Gastric Bypass: Etiology and Treatment OptionsGland Surgery 2016; 5(6): 617-624
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Updated on November 19, 2018

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