Darkangel505

Ya I was really wondering about his statement. It is so hard to know and so scary. Unfortunately a lot of doctors don't have a lot of sympathy for obese patients.

I don't think it can be avoided. Some people get gerd after vsg and others do not. But, people who do get gerd after vsg, it is not their fault. Unavoidable. Of course if you eat right before going to bed, it doesn't help the matter but here is a good link that explains in layman's terms why 35% vsg patients get gerd.
https://sampadocs.com/2019/12/23/reflux-after-gastric-sleeve/

Here is another very recent study if you would like to read it. It goes into the 3 reasons which contributes to gerd post-vsg, one reason is the shape of the sleeve. It is a hot topic now. https://www.jnmjournal.org/journal/view.html?uid=1643&vmd=Full

My surgery date has been scheduled for 11/14 and I'm starting to get scared. I am opting for the Sleeve, but I am concerned about GERD. My doc says the majority of those cases he sees are due to eating habits. I am hoping I can avoid that. I still just don't know I am making the right decision. Just really getting cold feet. I was hoping I'd get past this by now.

Medical Groups Replace Outdated Consensus Statement that
Overly Restricts Access to Modern-Day Weight-Loss Surgery
NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery.
The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it.
The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world.
"The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.”
In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied.
New Patient Selection Standards — Times Have Changed
The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.”
But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5.
Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery
The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.”
It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide.
Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S.
“The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.”
The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.”
About IFSO
The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity.
About ASMBS
The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

My results with the sleeve are completely different. I DO get sick eating sugar, rich foods, etc. It has been 8 years since my surgery and I have kept the weight off (100+ lb. weight loss).

Okay I went to the dentist today and he said my issues would not be related to my surgery. My chipped fillings he is guessing have to do with teeth clenching or grinding. Anyways, just wanted to update that it definitely doesn’t have to do with surgery.

Nutritional yeast (adds an aged cheese flavor)
chia seed pudding (make with a Protein Shake to add protein)
Ground flax seed (use in oatmeal or make flax crackers )
hemp seeds (also a good source of protein)
psyllium husk powder (what benefiber is made from) can be mixed into muffins, pancakes, or crackers. A little goes a long way!
Cocoa powder

I think it’s pretty rare & that the horror stories may be popular simply as a scar tactic from those anti surgery or simply that they’re a good story. I wonder if the odd cases were actually from pre existing conditions or there was a potential for future dental issues like years of eating a poor diet. Like I had reflux before surgery so the possibility of damage from rising stomach acid is a pre existing possibility.
Personally, I’ve had no issues at all. My dentist regularly gives me a gold star - a lifetime ago he was my PE teacher LOL!

no - a lot of people do not have these issues. Although it can happen, it doesn't seem to be a common thing. I've been on this site over seven years, and have seen maybe two posts from people who are having tooth issues. I also talked to my dentist about this before I had surgery, and he said although he'd read about it in the professional literature, he's never seen it in his patients who've had WLS.
my dentist said decay is usually caused by acid, and the people who have these issues are likely frequent vomiters or have untreated GERD. I was still freaked out about it, so he prescribed a super high-fluoride toothpaste for me to use before going to bed, and he also puts a fluoride varnish on my teeth every six months. To be honest, I think he probably did this just to placate me because I was so worried about it.
if you stay on top of your supplements, take care of your teeth, and have regular dental checkups, you'll likely be fine.

I am pre-op and I will tell those I trust most (which is only a few people) and no one else. I have absolutely no desire to hear the judgmental people in my family, or acquaintances, belittle my choices or question every bit and tell me why I was wrong. I will tell those that I had some stomach/gall bladder/hernia surgery which with a dietitians help, am losing weight. I'm just personal with certain things and I like to keep certain things to myself.

Hi! I had heartburn regularly before surgery. Not every day but frequently i had to take pepcid and tums.
Immediately following surgery it was worse and i was taking prescription pepcid twice daily, im 2.5 months out no and no longer take it most days. I need one pill every 4-5 days so its definitely improving.

Best thing I ever did for myself. Loving life again.

I had the sleeve done 12/2021. I was scare about GERD as well. My doctor said I had a small hernia and I've had GERD for over 30 years. However, it seems that since my surgery I don't have it as bad. I take Nexium once or twice a week and that seems to help me. I also take a good probiotic. Hope this helps a little. Good luck.

If I were you I would ask your surgeon his statistics. How many of his patients have had to convert to bypass because of GERD. From what I have heard on here for the past 16 months it seems like for the most part it is people who already had some issues with GERD and it gets worse post surgery. And many times it’s manageable with PPI’s but I do see those who have to convert to bypass.

All surgeries have some sort of side effect or risk. Often they’re related to a pre-existing condition or a pre existing predilection. Sleeve surgery has relatively few side effects. Yes, gerd is a possibility. I agree with @ShoppGirl’s advice to ask your surgeon for their stats.
I had mild reflux before my surgery which I managed with diet & only rarely needed to take a ppi (couple of times a year). I still have reflux. It manifests differently but I still manage it a lot with my food choices & take a ppi every day. None of the others I know who had sleeve surgery have developed gerd so …
You usually hear about complications on forums, etc. because those people are seeking advice & support. People usually don’t post to say everything’s going great (though many of us here do 😉). I also think people are quick to share a so called ‘horror’ story because they are’t supportive of your choice to have the surgery. Everyone’s got a horror story to share about just about anything. You know those a friend of a friend of a friend stories. Actually talk to people who’ve had the surgery or read through the responses on this forum & you’ll find out about other’s true journeys. (Avoid Facebook groups as the ones I’ve stumbled upon tend to be negative & promote ways to cheat the surgery.)
All the best.

You are over thinking it as we all did, I had gerd before surgery I was on 40mg nexium as well as gaviscon liquid and tablets just to keep on top of it. I now take 20mg nexium and that's it and I am not sure I even need that but haven't been game to come off it yet. My surgeon said weightloss would help my gerd which it did. I have noticed the people who get gerd and revise to bypass also had a substantial weight gain as well. I have had zero issues with keeping food and drink down, had a few little omg I shouldn't have eaten/ drunk that so quick but after a few minutes it's all good and you don't do it again lol but honestly I a a week away from 12 months and I have zero problems. At the moment I am recovering from covid and I am suffering from lack of desire to eat or drink and have a bit of nausea but that's from covid not surgery.

I originally wanted sleeve but I had severe GERD. My surgeon said it was my choice but gave me his input for why he suggests Bypass. Explaining that it is more likely that sleeve patients end up with GERD even without having prior issues; while is tends to relieve (cure) GERD with Bypass patients.
My GERD was horrible, I mean HORRIBLE! I was on 2 prescriptions plus eating tums regularly and still had regular issues. Up a lot of nights vomiting fire! Some times so bad my voice/throat would be hoarse for days after and episode.
Long story short, I opted for bypass. No regrets. 3 months out and I am off ALL GERD medications and haven't eaten any tums. No sign of acid /GERD problems!

Hi all,
I am working my way through my appointments to get my surgery. I am planning on the gastric sleeve as the bypass concerns me about internal hernia and malabsorption issues. I think the sleeve is the best choice for me, but I am concerned about chances that GERD will happen and I will be forced to get a revision to a bypass anyways. Have a lot of people had this issue? I am also worried about some horror stories I have read where people can't eat or keep food down or even eat. Are there a lot of situations like this? I'm probably overthinking a bit, but I know this is not reversible and I want to make sure I weigh all my options. Thanks for any help.