Acid reflux, Sleeve Gastrectomy, Gastric Bypass

Acid Reflux, Sleeve Gastrectomy, Gastric Bypass

I’ve had gastric sleeve surgery and had acid reflux so bad my doctor did gastric bypass surgery. Now I have acid reflux worse. Can I be fixed? Or do I just have to live with it the rest of my life? Sincerely, Dwight

Dear Dwight,

At Houston Heartburn and Reflux Center, we believe that no one has to live with acid reflux disease. Acid reflux is a debilitating medical problem that affects every aspect of your life. Fortunately, we have reliable, effective and safe solutions for acid reflux. For instance, hiatal hernia repair with sleeve gastrectomy is a great solution for an overweight patient with acid reflux disease. An important caveat to this statement is that patient must properly worked up for GERD and surgery must be properly performed. GERD work up is crucial to confirm the diagnosis of reflux, stage the disease and accordingly tailor the best treatment option to the particular condition. GERD work up includes basic tests like upper endoscopy and ambulatory pH testing. You may feel heartburn, a burning sensation behind the breast bone, but you may not have acid reflux disease. This is typically found in patients with a hypersensitive esophagus. Neither a sleeve nor gastric bypass will help you eliminate the sensation of heartburn in this case. You may have an esophageal motility problem like achalasia or a gastric emptying issue like gastroparesis. Both conditions limit the effectiveness of gastric bypass in alleviating your symptoms. In addition to proper workup and patient selection, anti-reflux surgery must be perfectly executed to stop reflux. This is particularly relevant to gastric sleeve surgery. Gastric sleeve must be properly contoured with no narrowing or twisting. Hiatal hernia must be completely reduced, and distal esophagus fully mobilized. Short of perfectly executing these steps, acid reflux is not likely to resolve.

My recommendations for you is to be properly tested for GERD using upper endoscopy, ambulatory pH testing, esophageal manometry and upper GI contrast study. Acid reflux in the setting of gastric bypass was covered in previous blogs and can be fixed. Hope this helps.

Dr. Darido