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Frequently Asked Questions about the 5 Day Pouch Test: If you have a question about the 5 Day Pouch Test it has probably been asked before. Peruse our most popular questions shown here to get answers.

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Will my pouch shrink by doing the 5DPT

Will this work for my WLS procedure?

Is it too late for me?

How soon after WLS can I do the 5DPT?

What does "broken my pouch" mean? I am pre-op and do not understand the term.

What are "Slider foods"?

I'm starting the 5DPT tomorrow, what do I need to know?

What happens after the 5 days?

What are liquid restrictions?

How often should I do the 5 Day Pouch Test?

Why do I need to take only 15 minutes for meals? My center told me to take 30 minutes for each meal.

What are Kaye Bailey's credentials?

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Will my pouch shrink by doing the 5DPT?
The 5 Day Pouch Test is first intended to allow your pouch to rest, just like right after surgery. Next, it is a chance to go through the stages of the post-surgery diet in a quick and practical time period. During this time you should feel a tightness in your pouch, particularly if you have been eating slider foods or drinking liquids with your meals. The focus on proteins will help bring your metabolic hormones into balance (vs. insulin highs and lows) which will help burn fat and reduce hunger cravings. The purpose is not to lose weight, however, many people report weight loss as a happy side effect to gaining control of their eating habits and returning to a protein adequate diet.

Will this work for my WLS procedure?
A: The 5DPT has been successfully completed by men and women with all surgical procedures. All case studies report returning to the high protein, low carbohydrate diet following completion of the test.

Is it too late for me, my surgery was a few years ago?
Only you can answer this question. I know of people who had bariatric surgery back in the 1980's --when the procedure was a simple staple line down the stomach-- who have successfully done the 5DPT. Many times when people ask me if it is too late to do the 5DPT it is out of fear: fear they will learn their pouch no longer works or fear they will learn the pouch does work. The simple back to basics 5DPT will not cause harm and it is only 5 days of your life. So it is up to you to decide if it is too late.

How soon after bariatric surgery can I do the 5DPT?
Without exception patients must follow the dietary program directed by their bariatric center for the first year following surgery. No exceptions. I do not recommend or encourage anyone in the first year post-surgery to do the 5DPT. Please, follow the plan your center prescribed specifically for you.

I'm starting the 5DPT tomorrow, what do I need to know?
I am surprised at how often I'm asked this. Usually the question comes in an email time stamped 11 p.m. the night before! I know there is a perception that the 5DPT is just about a 5-day eating plan and I've read, "easy-peezy, just do liquids, then soft food, then protein and that's all there is to it." When people take this approach they may lose a few pounds (and quickly regain them), but more damaging, they do not return to the early post-op behaviors, diet, and lifestyle that contributed to weight loss in the begging thus putting obesity in remission. A successful 5DPT needs to be scheduled, planned, and done with mindfulness and intent. Grocery shopping and meals should be prepared in advance when possible. There is as much mental work as kitchen work in preparing for the 5DPT and transitioning back to your post-WLS program. Use the free downloads (Click Tools on this site) and make sure you fully understand the plan. I understand when enthusiasm and hope strikes we need to take quick action to harness that energy. The key to sustaining that energy is knowledge. Read all you can about the plan, don't just dismiss it at "easy-peezy," -- doing so leads to disappointment. Read this website. Get the books if you like, or download the The 5DPT: Express Study Guide - Just $3.95 Instant Download - the quickest way to get a grasp of the plan as it is intended to be done to enable your success.

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ANSWER

What does "broken my pouch" mean? I am pre-op and do not understand the term.
Great question. In the early weeks and months following gastric bypass and gastric banding surgery there is a distinct feeling of tightness in the small stomach pouch created by the surgery. It feels tight because it is very small and because patients eat a meal compliant to instructions which is high in dense protein, void of starches including processed carbs and limited vegetable and fruit carbohydrate. New patients also comply with liquid restrictions, which ensure the pouch feels full when eating a small meal. This tightness works to trigger satiation for the patient, to signal fullness.

As patients get further out from surgery there is a tendency to experiment with the pouch, perhaps including liquid with meals or eating foods that exit the pouch quickly, commonly called slider foods. In the worst case slider foods are consumed with liquid, say graham crackers and coffee. In this case the coffee and crackers create a slurry in the pouch and slide right through the outlet to the intestine, thus never filling the pouch. Caught quite unaware by this patients ask, "Is my pouch broken?" They report their pouch does not feel the same tightness as it did early post-op when the pouch was new and they were compliant with the prescribed way of eating. When patients do the 5 Day Pouch Test they are most often surprised to feel the pouch again simply by returning to the way of eating that worked in the first place after surgery.

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What are "slider foods"?
In a malabsorptive procedure the pouch is made and the stoma or outlet is attached to the lower part of the middle intestine called the jejunum. The majority of caloric absorption takes place in the jejunum, so depending upon where your surgeon created the outlet the level of absorption can vary. Skilled surgeons will adjust the length of intestine bypassed according to their patient's projected needs based on dieting history and pre-op psychological screening.

Slider foods slide right through the stoma into the jejunum. My first test of the slider foods was graham crackers and coffee for my after work snack. Now imagine, I could eat a stack of graham crackers and wash it right through the pouch with the coffee and never feel any satiation. What resulted was an easily absorbed slurry that my jejunum sucked up like a sponge - it didn't have to do any work to absorb this simple carbohydrate slurry. Of course, weight gain resulted and I had to give up this little indulgence. Another popular slider food is pretzels. I speak with post-ops all the time who are addicted to pretzels - again, this is a simple carb that your jejunum is very happy to receive and convert to fat. Traditionally dieters are encouraged to eat pretzels or popcorn - fat free and fiber, right? But that doesn't work so well for us. Giving our re-routed bodies these simple carbs is dangerous because our bodies have spent years perfect the art of fat storage - slider foods are to the body a great big lottery win.

Featured Article: Slider Foods Spell Weight Gain for WLS Patients


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What happens after the 5 days?
After the 5 Day Pouch Test is when things get exciting. Having successfully broken a carb-cycle, regained a feeling of control over the surgical gastric pouch and possibly losing a few pounds one is ready for re-entry into a compliant way of eating. This means focusing on protein rich meals, observing the liquid restrictions and avoiding starches, particularly processed carbohydrates and slider foods. Three meals a day should be two-thirds protein, one third healthy carbohydrate in the form of low-glycemic vegetables and fruits. Consumption of whole grains is not forbidden, but should be limited to one serving a day.

If necessary between meal snacks should be protein dense. Natural food protein is great including hard-cooked eggs, lean low-sodium deli meats, and limited servings of nuts or low-fat cheese. In addition, protein bars or beverages may be used for between meal supplementation.

Patients should drink at least 64 ounces of water a day and take their prescribed supplemental vitamins. Caffeinated beverages should be limited to one or two a day and carbonated drinks are discouraged. Alcoholic beverages should be limited to one per day or less.

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What are liquid restrictions?
After bariatric surgery weight loss patients are advised to avoid drinking water 30 minutes before meals and 30 minutes after meals. (The time restriction varies from surgeon to surgeon, but most use the 30 minutes before, 30 minutes after restriction. Follow your surgeon’s specific directions.) In addition there should be no liquid consumed while eating. Following these liquid restrictions allows the pouch to feel tight sooner and stay tight longer, thus leaving the patient feeling satiated for longer periods of time without experiencing the urge to snack.


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How often should I do the 5 Day Pouch Test?
If a patient is following the program outlined by their center, if they are losing or maintaining weight and feels energized and in control the 5DPT is not needed. It is a specific action to be taken when a patient needs a methodical method for getting back to the basics of post-WLS living. It is not a gimmick or a trick diet; it is a method of taking control when things are out of control. Think of it as your bariatric airbag and hope you never need to use it. But if you do find yourself in peril this airbag is there ready to be deployed.

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Why do I need to take only 15 minutes for meals? My center told me to take 30 minutes for each meal.
Many bariatric centers recommend patients take 30 minutes for meals. Some even instruct patients to use a stop watch and time 3 minutes between bites of food. The reason is to slow down the eating habits of the recovering morbidly obese person. After some time patients who comply with the 30 minute meal rule tend to be able to eat more and often linger over the meal, even though satiation has resulted. Consequently they eat more food, particularly if they are not following liquid restriction and using liquid to wash the food through the pouch.

During the pouch test a person is following the liquid restriction and eating a high protein diet. By limiting the time to eat to 15 minutes one will enjoy the satisfaction feeling that is the desired result of a gastric pouch. The following is from the Gastric Bypass Owners Manual from Alvarado Hospital:

Understand Satisfaction:
"When you feel satisfied you are finished. Don't get trapped in the belief that you have to eat everything on your plate, or that you can't possibly get by with that small a meal. Your meals will be small, and they are supposed to be small. If you feel full and satisfied and you try to eat any more you will begin to feel nauseated and you may throw-up. The point is not to see how close you can come to nausea. Learn to eat until satisfied and to avoid getting sick."

Kaye Bailey developed the 5 Day Pouch Test in 2007 and is the owner of LivingAfterWLS and the 5 Day Pouch Test websites. Ms. Bailey, a professional research journalist and bariatric RNY (gastric bypass) patient since 1999, brings professional research methodology and personal experience to her publications focused on long-lasting successful weight management after surgery.

Concerned about weight regain her bariatric surgeon advised her to “get back to basics”. With that vague advice Ms. Bailey says, “I read thousands of pages and conducted interviews with medical professionals including surgeons, nutritionists, and mental health providers. I collected data from WLS post-ops who honestly and generously shared their experience. My research background gave me the methodology to collect a vast amount of data. As a patient I found answers to the questions and concerns I have in common with most patients after WLS.”

Kaye Bailey is the author of countless articles syndicated in several languages, and books available in print and electronic format including The 5 Day Pouch Test Owner's Manual 2nd Edition 2012, (1st Edition 2008 out-of-print, 50K copies in circulation); Day 6: Beyond the 5 Day Pouch Test (2009 – 3rd Printing January 2015); Cooking with Kaye Methods to Meals: Protein First Recipes You Will Love (2012).

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