Vertical Sleeve Gastrectomy (VSG) vs Gastric Bypass (GB)

[docbree 199]

I'm interested in hearing how people who have already had surgery decided between the sleeve and bypass. I'm really leaning toward the sleeve as I have RA and will most likely need prednisone/NSAIDs periodically for the rest of my life. One of the two bariatric surgeons I interviewed really seemed to think my significant GERD would likely become worse with the sleeve. She thought if I lost enough weight I might not need anti-inflammatories - but that's a big "might not" and a lot to gamble with. I do also have a hiatal hernia, so there's a chance that fixing that plus weight loss might actually improve the GERD - so many unknowns...

Has anyone had the Linx procedure for reflux either with or after the sleeve instead of revision to bypass? BTW - the surgeon who was worried about worsening GERD is a specialist in this procedure.

Maybe I'm overthinking all of this - just don't want to do something for my health and then end up in worse condition than I am now.

Thanks for any replies.

Brenda

[brown eyed gal 59]

I don't have R.A. but I realize your concern. I have GERD and Barrett's Esophagus, meeting with surgeon tomorrow but I have read and heard that they really recommend RNY. Although...several people have had the sleeve and it helped their Gerd.

[docbree 199]

I don't have R.A. but I realize your concern. I have GERD and Barrett's Esophagus, meeting with surgeon tomorrow but I have read and heard that they really recommend RNY. Although...several people have had the sleeve and it helped their Gerd.

Thanks, Aiderbellou. I appreciate you responding to my post. I guess I need to have another conversation with my surgeon before making a final decision. Good luck with your procedure!

[CowgirlJane 14,261]

Look at the studies... the risk of GERD post sleeve is significant. I read a study that showed that many people are fine but at 3-6 years out the GERD becomes a big deal. I love my sleeve, but I think you should seriously discuss this situation with surgeons. There are a couple of successful sleevers who have had to revise to bypass over the GERD issue.

[docbree 199]

Look at the studies... the risk of GERD post sleeve is significant. I read a study that showed that many people are fine but at 3-6 years out the GERD becomes a big deal. I love my sleeve, but I think you should seriously discuss this situation with surgeons. There are a couple of successful sleevers who have had to revise to bypass over the GERD issue.

Thanks CowgirlJane. I will do that!

[Chelly 364]

I was originally going to have the sleeve and a few weeks before my gastric doctor told me because of GERDS I shouldn't have the sleeve and should have the bypass because the risk is higher that the GERDS will get worse with the sleeve. I followed what he said and also my surgeon agreed that bypass was the best for me.

I have fibromylgia, stenosis of the spine, RSD, and osteo arthritis and I have dealt well with out NSAIDS or pain meds since loosing all this weight.

Talk to your surgeon and talk to a gastric doctor and see what they have to say about what you should do.

Good luck with your decision of what to do.

[Bring It On 55]

There were 2 reasons I chose RNY over the Sleeve. 1) I am Diabetic, 2) I have severe acid reflux. I have been on Nexium for 5 years. My surgeon told me that most of his patients that he had done the Sleeve on had experienced moderate problems with acid reflux. It is my goal to get off ALL of my meds, so it was a easy choice for me. They were able to use my Upper Endoscopy that was done last year, but my surgeon told me that if I had been diagnosed with a hiatal hernia, it would have to be repaired before or during surgery.

Good luck with whatever surgery you and your doctor decide is best for you!!

[New nana 30]

I have reflux but my gastroenterologist and bariatric surgeon agree that the sleeve is best for me. They concur that losing the weight will automatically decrease my reflux. I will be on Prilosec for a while postop and then they hope to wean me off of that as well. I take Prednisone periodically for asthma and I also have a small hiatal hernia. He is fixing the hiatal hernia while he is in there for my sleeve. He said that the prednisone will be fine, in bursts, postop as long as I take my prilosec with it. I did not want the malabsorption and dumping issues that often result post bypass. Good luck with your decision. I am so excited. My surgery is Monday! First Case!! :D

[CowgirlJane 14,261]

I thought for months about reflux before getting sleeved.

I never had it until I was banded.. then it really harmed my life. I had to have a propped up bed; haf to stop eating early, had low level pain and I didn't have support so I didn't know I should be on a PPI. I was miserable and ate a lot of yogurts, ice cream and other soothing foods.

Best thing was my band was removed and I was ravenous. Like I didn't think the band did anything but it did!

One day I decided that I would accept being medicated for reflux forever over staying huge...who I am I kidding. ..I was super morbidly obese and gaining. ... I thought about it a long time though. Then I took the sleeve plunge.

2.5 years out. No reflux!!! Keeping fingers crossed. I have a "bigger" sleeve and got to goal.

Edited August 13, 2014 by CowgirlJane

[docbree 199]

I have fibromylgia, stenosis of the spine, RSD, and osteo arthritis and I have dealt well with out NSAIDS or pain meds since loosing all this weight.

Talk to your surgeon and talk to a gastric doctor and see what they have to say about what you should do.

Good luck with your decision of what to do.

I am so glad you're doing well and no longer need NSAIDs or pain meds! I appreciate your feedback - it sounds like you and I have similar issues

[docbree 199]

There were 2 reasons I chose RNY over the Sleeve. 1) I am Diabetic, 2) I have severe acid reflux. I have been on Nexium for 5 years. My surgeon told me that most of his patients that he had done the Sleeve on had experienced moderate problems with acid reflux. It is my goal to get off ALL of my meds, so it was a easy choice for me.

Good luck with whatever surgery you and your doctor decide is best for you!!

I really hope you are able to accomplish your goal and get off all meds - that would be wonderful! Thank you for your comments!

[docbree 199]

I have reflux but my gastroenterologist and bariatric surgeon agree that the sleeve is best for me. They concur that losing the weight will automatically decrease my reflux. I will be on Prilosec for a while postop and then they hope to wean me off of that as well. I take Prednisone periodically for asthma and I also have a small hiatal hernia. He is fixing the hiatal hernia while he is in there for my sleeve. He said that the prednisone will be fine, in bursts, postop as long as I take my prilosec with it. I did not want the malabsorption and dumping issues that often result post bypass. Good luck with your decision. I am so excited. My surgery is Monday! First Case!! :D

Your post is very interesting and gives me hope I am so excited for you - good luck Monday!!!

[docbree 199]

I thought for months about reflux before getting sleeved.

I never had it until I was banded.. then it really harmed my life. I had to have a propped up bed; haf to stop eating early, had low level pain and I didn't have support so I didn't know I should be on a PPI. I was miserable and ate a lot of yogurts, ice cream and other soothing foods.

Best thing was my band was removed and I was ravenous. Like I didn't think the band did anything but it did!

One day I decided that I would accept being medicated for reflux forever over staying huge...who I am I kidding. ..I was super morbidly obese and gaining. ... I thought about it a long time though. Then I took the sleeve plunge.

2.5 years out. No reflux!!! Keeping fingers crossed. I have a "bigger" sleeve and got to goal.

I'm so glad you're doing so well and have no reflux! Congratulations and thanks for the inspiration!

[docbree 199]

Thank you so much to everyone who responded - you've given me a lot to think about and different points of view. I am going to make a summary of the pros and cons of both procedures and talk this over again with my surgeon. I will let you know what I decide - surgery is supposed to be in 3 months

[sunnkistme 76]

I just posted the same question. The nutritionist suggested bypass over sleeve because I would be less likely to abuse sugar. I have sugar binge issues. I had pretty much decided on the sleeve but am wavering on my decision now. Tough call.