HELP! Sleeve vs RNY

[VSGAnn2014 12,992]

Good list, @@JamieLogical , and good discussion.

I had a sleeve and had mild reflux pre-op. Twenty-one months post-op, I still have mild reflux that's controlled by an H2 blocker antacid Rx (Ranitidine HCl 150 mg. taken twice a day), which is the same med I took pre-op.

I try to follow most eating instructions for those who have GERD, e.g., I stop eating at least two hours before going to bed at night, and minimize eating / drinking acidic foods at night, e.g., Tomato sauces, sweet foods, coffee, etc.

During the first four months post-op, my surgeon changed my antacid to a PPI (Protonix). Then I went back to Ranitidine.

IMHO, there is no generally superior bariatric surgical choice. Your best choice depends on your own medical situation and your comfort with the choices.

And don't forget -- for some patients, there are nearly half a dozen other WLS choices besides sleeve or bypass that might be better for you.

[Pup 217]

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself:

• low starting BMI, no real need for the malabsorption
• hated the idea of my intestines being rerouted
• hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy
• more joins meant more potential for leaks
• didn't want to lose the use of my pyloric valve
• saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient
• didn't like the idea of dumping syndrome
• the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out
• higher risk of late onset complications years down the road

Thanks you!!! This was very informative.

I do have mild reflux. This was really the only reason my surgeon brought up bypass. But it is controlled well enough with a proper diet that he said I may be okay with the sleeve.

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I had GERD, so I went with bypass. GERD is completely gone. I've had no "side effects" other than two strictures early out (which are an easy fix). I don't dump, either.

I think I am worried that I am going to be the person that dumps all the time

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Dumping doesn't worry me...I am looking at it like it's another tool for weight loss. Easy for me to say no it hasn't happened LOL

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[JamieLogical 8,727]

@@Pup Some people actually have dumping syndrome on their list of reasons in favor of RNY. The problem there is that there is no guarantee you will have it at all or that it will last past the first few months. So relying on it as a deterrent from eating sweets could be a mistake.