Will I have worse reflux after my Sleeve Gastrectomy?

Gastroesophageal reflux, or GERD, is often called heartburn or regurgitation. Many people have occasional reflux and heartburn, but for some who suffer with the symptoms every day, it is a bothersome disease that requires they take daily medication for heartburn. The best treatment for heartburn depends on an individual’s medical history and physical exam. For patients that qualify for weight loss surgery, the best treatment may very well be a gastric bypass, sleeve gastrectomy, or gastric banding.

ALL weight loss surgery improves GERD in most patients, but some patients complain of their heartburn getting worse after surgery. This is particularly true for gastric bands (5-10%) and sleeve gastrectomy (15%). The real question is why. What is going on that some patients have worsening symptoms after surgery if these operations help most people get off their reflux medications?

New data from a randomized controlled trial conducted by several surgeons of the MIST group at the University of Texas Health Sciences Center at Houston may give us some clues into this problem. Our data showed that age, presence of hiatal hernia, repair of hiatal hernias, and even weight played no significant role in a patients’ post-sleeve reflux symptoms. The only thing that mattered was how much reflux they were having before the surgery. Patients with worse symptoms seemed to do better after surgery compared to those patients who did not have severe symptoms before surgery. While this data does not give us all the answers, it may help us make predictions about what the best surgery would be for individual patients with reflux disease.

The gastric bypass surgery, also called the roux-en-Y or just the bypass, is the best surgery for reflux in patients who need weight loss surgery, but not everyone wants a bypass or is the ideal candidate for it. Therefore, we need to keep all our options open and try to predict post-surgery symptoms related to reflux for each individual patient.

If you have reflux or heartburn, whether you need weight loss surgery or not, then maybe it is time to do something more about it than take a pill, especially if that pill is no longer working. Make an appointment to see me today, and let’s figure out how to make you heartburn free.