Can Liquids Stretch Your Sleeve?

Written by Sherry Vickers and medically reviewed by Dr. Stephen Boyce, MD

“Is it possible to stretch my sleeve after surgery?” Many vertical sleeve gastrectomy patients have probably asked this question at one point. Directly after surgery, the restriction is real. Drinking water even seems like a feat! But once we start to heal and eat normal foods again, there are days where we wonder if our surgery even worked. At times, we even panic a little wondering if we’ve overdone it, stretched our new stomachs, and ruined our outcome.

Relax! Stretching your new stomach back to its pre-surgery size likely isn’t going to happen. And here’s why:

Your post-op stomach

The before and after of your stomach following gastric sleeve surgery

During a vertical sleeve gastrectomy, the outer portion of your stomach is completely removed, leaving a “sleeve” roughly the shape and size of a banana. The stomach tissue removed is largely the area that expands and contracts to accommodate food and is also the part responsible for secreting the hunger hormone called ghrelin.

Think of it this way:

If you cut the bottom of a sock off from heel to toe, threw away the cut off portion, and stitched back together the rest, you could never stretch the “new” sock enough to accommodate as much as the original sock. There just wouldn’t be enough fabric there to do it.

However, not all of the tissue that expands and contracts is removed, which allows your new stomach to continue to function properly. Your sleeved stomach still expands and contracts, but because it’s capacity is much smaller, you feel full from only a small portion of food.

Stretching Your Sleeve – FAQ’s

I can drink a lot of liquids. How is this possible if I am not stretching my pouch?

Liquids pass through the stomach quickly and without restriction. Unlike with solid foods, your stomach doesn’t hold onto liquids in order to break it down into a passable consistency. In this case, your stomach acts as a funnel for liquids to pour into your body.

Liquids pass through a sleeve gastrectomy stomach more quickly than food which takes longer to digest

Why can’t I have carbonated beverages post-op? They’re just liquids too, right?

Carbonation is air, and air in your new, tiny stomach can cause extreme discomfort. While carbonated beverages won’t cause your stomach to overstretch, they can cause bloating, gas, indigestion, pain, and uncomfortable feelings of fullness.

Filling your stomach with bubbles also takes up space that could otherwise be occupied by nutritionally dense foods. Because portion sizes are so limited after surgery, it is particularly important to make sure what we do put into our bodies is helping us meet our nutrition requirements.

Is it possible to permanently stretch my sleeve?

Over time, your sleeve is going to naturally stretch a bit. Especially the farther out you are from your surgery date. Although it will likely never return to its pre-surgery size, it is possible to stretch it enough to lose the desired restriction you once had. This happens from regularly overeating. This is why we need to constantly be aware of our portion sizes, eat our meals on a schedule, and not graze all day.

And even though you can’t physically undo the surgery, you can interrupt your brain’s full signals, causing you to think you’re hungry even when you’ve eaten enough.

Hunger signals being sent to your brain even though there is enough food in the sleeve gastrectomy stomach

I have read about people doing a pouch reset to get their sleeve back to how it was just after surgery. What is it, and should I try it?

Pouch Reset diets are high protein, low volume diets to help “reset” your hunger point.

There is no such thing as a “pouch reset”. Not from a physical standpoint, anyway.

Your stomach naturally expands when you eat. Then, it returns to its pre-meal size. There’s no magic program that will launch you back to where you were right after you had surgery. At that point, your restriction was extreme because you were sore and swollen. The actual capacity of your pouch hasn’t changed since the surgery. You’ve just healed.

Progression of the 4-phase diet after sleeve gastrectomy surgery

In the beginning, you start with liquids and slowly progress to solids over the course of several weeks in order to allow you to heal. It has nothing to do with how big your sleeve is. Returning to those eating stages as a way to reset doesn’t make sense, because those stages had nothing to do with how much your sleeve could hold.

So, what you need to know is…

I have mentioned it before, and I will mention it again…your stomach is highly unlikely to ever see its former size again. Your surgeon removed about eighty percent of your stomach; it isn’t going to magically grow back!

Even though it may feel like you’ve done physical damage if you are finding that you are able to eat much more than you anticipated it is most likely a mix-up in hunger signals.

Therefore, it is extremely important for you to develop healthy eating habits before and after surgery. As you’ve been told time and again, sleeve surgery is just a tool to help you lose weight. If you fail to do your part, the weight will come back.

When you eat, your stomach sends a signal to your brain to let you know that you have consumed enough food. Over time, if you choose to ignore this full signal, your brain stops getting the message as quickly. You will find that you can stuff more and more in before the message sinks in loud and clear.

After surgery, you need to measure your portion sizes and stick to them!

Just because you can’t eat a lot at once doesn’t mean you can’t do extensive calorie damage in a day. If you eat frequently instead of sticking to defined mealtimes, you can eat just as much as you did pre-op.

For example, if you could eat a large plate of pasta before having surgery, and you serve yourself the same sized plate of pasta after surgery, you may not be able to eat it all at once. But if you take a few bites over the course of an hour or so, you will have consumed the same amount as before you were sleeved.

Eating smaller amounts of pasta after sleeve gastrectomy surgery over time can add up to one large serving

It isn’t because you stretched your sleeve, it’s because you spread out your mealtime instead of controlling your portion size, to begin with.

The Bottom Line

The number one rule you need to remember post-op is to practice healthy habits and mindful eating! If you do not master this, you will not have long term success. Even though your sleeve may stretch a bit from constant overstuffing, there is no way you are getting your pre-surgery stomach back.

If you have gotten derailed, you don’t have to do any drastic reset programs to get back on track. Just make the next right choice. Go back to your surgeon’s nutrition plan and align your diet to it. Track your protein intake, plan your mealtimes, drink your water, and take your supplements. Your surgery and plan were designed with your WIN in mind!

Do what you need to do, and you’ll end up where you need to be.

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