Lap Band Revision Surgery Houston

Is Sleeve surgery a good option for patients with heartburn?

The incidence of heartburn in our overweight patient population is very high. Heartburn results when acid backs up into the esophagus. Normally, a competent lower esophageal sphincter, LES, acts as a barrier against acid reflux into the esophagus. With weight gain, fat accumulates inside the abdomen increasing the pressure on the stomach and leading to acid reflux. Furthermore, a higher intra-abdominal pressure increases the incidence of a hiatal hernia. A hiatal hernia occurs when part of the stomach herniates into the chest thereby leading to a weak LES. To make things worse, overweight individuals tend to overeat especially at dinnertime. Overeating stretches and weakens the LES, further aggravating the reflux of acid. Delayed gastric emptying and a dilated gastric fundus (upper part of the stomach) promote the development of a permanent “acid bubble” in close proximity to the LES which in turn may contribute to the increased incidence of acid reflux in this patient population.

At Houston Weight Loss Surgery Center, we offer the sleeve gastrectomy for most patients with a body mass index (BMI) higher than 35 and suffering from heartburn. Sleeve surgery allows for long-term effective weight loss leading to alleviation of most acid reflux symptoms. Sleeve gastrectomy is currently the most commonly performed weight loss procedure around the world. During sleeve surgery 85% of the stomach is resected ending up with a banana shaped stomach. As you loose weight following sleeve surgery, heartburn tends to resolve. A recent study published in the Annals of Surgery by Dr. Morino showed that heartburn resolves after sleeve gastrectomy in the majority of patients who suffered from gastro-esophageal reflux disease (GERD) prior to surgery. The study also showed that new onset acid reflux after sleeve gastrectomy is rare. Interestingly, the study demonstrated that sleeve surgery increases the pressure of the lower esophageal sphincter, LES, hence strengthening the acid reflux barrier. This is an additional anti-reflux property for the sleeve that is independent of weight loss.

At Houston Weight Loss Surgery Center, the only contraindication for sleeve surgery in GERD (gastro-esophageal reflux disease) patients is the presence of Barrett’s esophagus. Barrett’s esophagus results from long standing severe acid reflux and possible bile reflux into the lower esophagus. In this case, gastric bypass surgery is a better option for weight loss. Gastric bypass diverts acid and bile from the lower esophagus therefore preventing and halting the progression of Barrett’s into cancer. Gastric bypass also preserves the rest of the stomach in case it is needed in the future for reconstructive surgery if esophageal surgery is ever needed.

If you have persistent heartburn and interested in weight loss, Dr. Darido offers state of the art effective solutions for both heartburn and excess weight. Please give us a call at 281.205.3205 for a free private consultation at Houston weight loss surgery center.