Acid Reflux

[Angelika 17]

I am booked for Gastric Sleeve July 27. I am seeing so so many people complain of Acid Reflux after surgery. Does everyone get it after the sleeve? I'm concerned about the dangers of long term reflux. Also now all the news about ppi medication reducing life expectancy 25 percent! Shocking news, making me rethink the surgery again.

[valkh 1]

Im a newbee and when deciding which surgery to choose ... my surgeon pointed out that the gastric bypass would be best for me because of my history of acid reflux. He suggested that the others were known to cause this.

[Angelika 17]

Thanks..

[Ldyvenus 317]

I am on prescription meds for acid reflux the first year post surgery. I haven't had any issues, I'm also curious to see what would happen if I stopped taking them...

[Navigating the Wilderness 824]

I had horrible reflux pre-op, but have not had a single problem post-op. Of course I am on Nexium, but pre-op it would have been Nexium, Tums, and still having bouts of horrible reflux.

I'm a firm believer that diet has a lot to do with reflux. Greasy foods, caffeine, high acid foods, and overeating all were causing my issues. Now that I pass on those I have no reflux problems.

[James Marusek 5,244]

I am 4 years post-op RNY gastric bypass surgery. I had severe acid reflux [GERD] prior to surgery. That is why I went with gastric bypass vs. sleeve; because the sleeve will only make this condition worse. I have not had a problem with GERD since surgery.

I used a PPI [proton-pump inhibitor] called Prilosec [Omeprazole] to periodically treat this condition prior to surgery. I also was prescribed this drug for the first year after surgery, in order to allow my stomach to heal. But after the year was up, I could tell the this condition was in remission.

You indicated that ppi medication reducing life expectancy 25 percent. GERD is a dangerous disease. It can lead to Barrets' esophagus, and many other problems. According to the internet:

GERD is most often not a life limiting disease. Approximately 23 million Americans have GERD. The chances of Barret's is pretty small and even then less then 10 percent with Barrets will develop esophageal cancer. An estimated 13,000 people in the US are diagnosed with EC each year, so it is pretty rare.

Everyone starts off with a normal lower esophageal sphincter and no reflux. The severity of GERD probably correlates best with the degree of damage to the sphincter, but this is not easy to determine in practice. These are the four stages of GERD:

Stage 1 – Mild GERD

The majority of adults today have minor damage to their LES [lower esophageal sphincter] and experience mild GERD occasionally. In most cases they either tolerate occasional heartburn or use over-the-counter acid suppressive medications with the onset of symptoms. Because their symptoms are controlled quickly, easily, and inexpensively with these drugs, their quality of life is unaffected.

Stage 2 –Moderate GERD

Stage 2 GERD is more difficult to control with acid suppressive drugs and reflux is more frequently accompanied by higher intensity symptoms. Damage to the LES is more extensive compared to Stage 1. Many symptoms can be satisfactorily managed long-term with acid suppressive medications. Over-the-counter medications often provide inadequate relief, so prescription strength medications are necessary to manage symptoms.

Stage 3 – Severe GERD

Stage 3 GERD results in a substantially lower quality of life and is considered to be a very serious problem. Prescription level acid suppressive drugs do not control symptoms to the individual’s satisfaction and regurgitation is frequent. It is also likely that one or more of the complications associated with erosive GERD may be present.

Stage 4 – Pre-cancerous condition or reflux induced esophageal cancer

Stage 4 is the result of many years of severe reflux. 10-15% of long-term sufferers progress to this very advanced condition. Due to long-term reflux, the lining of the esophagus has been damaged, resulting in cellular changes. Interestingly, these changes may occur in some with only minimal symptoms. Stage 4 involves the development of a pre-cancerous condition called Barrett’s esophagus, or a more severe condition called dysplasia. These conditions are not cancers, but raise the risk of developing actual reflux-induced esophageal cancer. At this stage, typical GERD symptoms may also be accompanied by burning in the throat, chronic cough and hoarseness. Strictures, or a narrowing of the esophagus, can also occur which is characterized by the sensation that food is sticking in the esophagus. This same symptom can also be caused by esophageal cancer.

So perhaps it is not the use of PPI that causes the lowered life expectancy but the damage from the disease itself. Anyways from my perspective there is treatment for this condition and that is RNY gastric bypass surgery.

[MelodyBronson 18]

I have been a sufferer of GERD for awhile (even before surgeries)...I had the sleeve several years ago and I suffered with GERD. I just recently had a revision from the sleeve to a by-pass and my GERD has greatly improved! I was told by my dr to continue taking my GERD prescription meds for now....but that eventually I will probably no longer have GERD. Good Luck!

[SleeveDreamer 383]

I had the sleeve 5 1/2 years ago. Recently my acid was so bad it was literally taking over my body and me! The doctor said the only thing to fix it would be RNY. So I had bypass on June 12th. No acid whatsoever now because the part of the stomach that produces acid is no longer there. If you suffer from bad reflux before your sleeve, I would suggest talking with your doctor to see if RNY is not a better option for you. IMO there is no difference in post op or recovery. It seems like a lot of people on this forum have had sleeve revisions to RNY down the road because of bad acid.

Edited July 7, 2017 by SleeveDreamer

[Sweet as peaches 759]

I had gastritis and they put me on prilosec which omg gave the worst reaction but after the sleeve i was put on protonix which worked wonders on my acid reflux don't know if I have gastritis still but i have no problems. Btw, I stopped taking prilosec after that bad side effect..

[OutsideMatchInside 10,166]

12 hours ago, Angelika said:

I am booked for Gastric Sleeve July 27. I am seeing so so many people complain of Acid Reflux after surgery. Does everyone get it after the sleeve? I'm concerned about the dangers of long term reflux. Also now all the news about ppi medication reducing life expectancy 25 percent! Shocking news, making me rethink the surgery again.

I never had GERD before surgery. The first 9 months I had issue off and on which could have been prevented if I took my PPI the whole time like I was supposed to. Now the only time it happens it is my fault, eating too much with an underwire bar on.

It doesn't happen to everyone or even most people. The percentage of sleevers with GERD is lower than the normal population.

It just seems common because it is the one complication that is common, as in there are few complications and this is one. Also it can be self inflicted and a lot of people that are food addicts don't stop after they have surgery. Constantly over eating does not help.

Also almost all the information about PPIs is BS. Look at the actual studies. I don't take a PPI regularly now, but if I had to take one for the rest of my life I would have no fear about it. It is better than the alternative.

[Little Green 582]

My surgeon told me 1/3 of VSG patients will develop issues with acid reflux after surgery. Whether that is full-on GERD, I don't know (although I doubt it). So, you have a 2/3 chance of not having any issues at all. I agree with @OutsideMatchInside, the people who are going to be searching on the internet for help are the ones who have complications. Sort of like vomiting or dumping after RNY - it seems like everyone has that issue but the stats my surgeon gave me disprove that.

Many meds have side effects... Tylenol and liver, Advil and heart, etc. But truthfully, being obese is going to reduce your life expectancy far more than taking a PPI long-term. (And that's assuming that stat is true, which sounds a little sensational to me.) So, choose the surgery that you think will be successful, and the one you can live with forever!

[shericrazylady 113]

I had it bad after surgery I'm almost 2 weeks post on and it has calmed down to only once a day before I was getting it all the time

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