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acid reflux after band to sleeve revision
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Here's my story, it's kind of long but I'll try to keep it short.
June 30th I found a revision surgeon in Mexico who was able to take out my band and do a sleeve in one surgery. He is board certified in bariatrics (in MX) and is the president of the Mexican College of Bariatrics.
Anyway, shortly after surgery, I got horrible GERD. Started off with one prilosec a day, quickly moved to two, and Gaviscon for symptoms, then on to dexilant. After a couple of days the dexilant wasn't working completely and I had to add some pepcids at night.
I went to a local bariatric surgeon and he told me that because I had the revision in one surgery, that there was absolutely no way that my sleeve was the right shape. He said that the surgeon would have had to cut around the area of the band, leaving an area where acid would get caught and cause GERD forever. He said my only options were either: to take PPIs forever for the GERD or revise to bypass. And, insurance would never cover the revision to bypass.
He said it was too early to do any kind of contrast study and told me to come back in three months.
Yesterday I ran across this story: https://houstonsleevesurgeon.com/interesting-case-severe-acid-reflux-after-gastric-sleeve-surgery/
This patient's case is so much like mine. She had GERD for 10 years and mine has just started, but similar. She was "placed on escalating doses of PPIs in hopeless attempts to control her symptoms" and had "an incompletely resected gastric sleeve". In other words, it was pretty much what the bariatric surgeon had told me: "A retained gastric fundus may contribute to intermittent relaxation of the lower esophageal sphincter leading to reflux. Furthermore the gastric fundus may allow for an acid pocket to form in the vicinity of the gastric cardia leading to acid reflux. A retained gastric fundus may also cause delayed gastric emptying further exacerbating acid reflux. The gastric fundus is a posterior structure and it can easily be incompletely resected during sleeve surgery. "
So, I contacted the doctor that wrote this and he wrote me back and we've emailed back and forth a bit. He is telling me that - if the surgeon left gastric fundus then it would be an easy fix to resect it and avoid conversion to bypass. He also said I would need endoscopy and a contrast study to determine what is going on with my sleeve. I see a GI on Tuesday and I hope he will help me with this. I'm excited about the prospect of getting rid of this GERD and keeping my sleeve, but this surgeon is in Houston. I'm in Florida. He suggested I find a reflux specialist or a surgeon here that could handle my case. If - the surgeon left fundus - I would have to find a surgeon here that would be willing to resect the fundus. That's clearly not the surgeon in town that told me "PPIs or bypass" I would have to find someone who would be willing to try the procedure that this Houston doc is suggesting. This is going to be difficult - and possibly expensive.
Edited by silverwhitemoon