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Barrett's Esophagus and Gastric Bypass



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Hello,

I was preparing for the gastric sleeve when my pre-op EGD scope showed I have Barrett's esophagus, with dysplasia (pre-cancerous). My WLS surgeon said I need to treat the Barrett's first and then strongly suggested I have the Gastric Bypass instead of the sleeve because of several reasons -- GERD is usually eliminated with bypass and worse with sleeve (acid is the cause of the Barrett's), and the stomach is left if needed for esophageal cancer surgery (worst case scenario, obviously).

My first priority is getting the Barrett's treated. Then, in four to six weeks, having the WLS surgery, which is recommended to also treat Barrett's (from an obesity perspective).

So, I'd like to hear if there are other WLS patients like me with Barrett's and what happened. I'm anxious for info!

I'm a bit in shock since I got the news today. But I consider it a blessing because if I hadn't gotten the scope, I could have had a much worse diagnosis later.

My May 30 surgery is now postponed, obviously. :(

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I know you posted this a while ago, but I was just browsing the lists and came across it, so I thought it's probably not too late to reply.

I was diagnosed with Barrett's in 2016, and at that time I was also told I had a large hiatal hernia. I was recovering from having my gallbladder removed and I felt like the warranty had just expired on my body. The surgeon said nothing was going to get better unless I had WLS--he was recommending sleeve.

Insurance company sent me to a different hospital in a different city, and that surgeon recommended RNY for all the reasons your surgeon said. I had the surgery in September of 2017, and I feel much, much better. After 2 months, I was able to stop taking the Prilosec and my high blood pressure meds. I haven't had a day of heartburn since. I still have to have a endoscopy done every 3 years, but that's minor compared to what the repercussions would be if I hadn't had the surgery. And I've lost 105 lbs!!

But a lot of people in my support group who had the sleeve done have just not had as good of results. So in the end, even though recovery and life after RNY is a little bit harder some days, I'm glad I had it done. I hope you've had your surgery by now and you're feeling better.

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3 minutes ago, jrmoseley said:

I know you posted this a while ago, but I was just browsing the lists and came across it, so I thought it's probably not too late to reply.

I was diagnosed with Barrett's in 2016, and at that time I was also told I had a large hiatal hernia. I was recovering from having my gallbladder removed and I felt like the warranty had just expired on my body. The surgeon said nothing was going to get better unless I had WLS--he was recommending sleeve.

Insurance company sent me to a different hospital in a different city, and that surgeon recommended RNY for all the reasons your surgeon said. I had the surgery in September of 2017, and I feel much, much better. After 2 months, I was able to stop taking the Prilosec and my high blood pressure meds. I haven't had a day of heartburn since. I still have to have a endoscopy done every 3 years, but that's minor compared to what the repercussions would be if I hadn't had the surgery. And I've lost 105 lbs!!

But a lot of people in my support group who had the sleeve done have just not had as good of results. So in the end, even though recovery and life after RNY is a little bit harder some days, I'm glad I had it done. I hope you've had your surgery by now and you're feeling better.

Thank you so much for your post! I loved reading about your experience. I had the ablation of my pre-cancer cells two weeks ago and my pre-op with my WLS surgeon on Friday. Now I’m just waiting for bypass to be scheduled. So I’ll be getting the RNY gastric bypass in a few weeks, fingers crossed! I’ve done a lot of research and spoken to several doctors, including my PCP and Gastroenterologost, and they all said the bypass was the best bet to cure GERD. And insurance approved it, even though I’m at 34 BMI. That alone says a lot, since they denied me for the sleeve even with comorbidities because I was too low a BMI.

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Background: I’ve had GERD for many many years, long time Prilosec user, and a family history of esophageal cancer.

I had MGB surgery in April 2017 and it resolved my acid reflux, but in Dec 2017 an EGD showed bile reflux, and then in April 2018 an EGD showed Barrett’s Esophagus and a hiatal hernia, which I never had before. Two different surgeons have recommended conversion to RNY to correct the reflux and to repair the hernia, so I will be having both of these procedures at the end of the month. I am also low normal BMI right now so I hope I don’t lose too much weight after surgery.

I’m looking forward to being free of all symptoms and resolution of pre-cancerous cells!

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5 hours ago, MarinaGirl said:

Background: I’ve had GERD for many many years, long time Prilosec user, and a family history of esophageal cancer.

I had MGB surgery in April 2017 and it resolved my acid reflux, but in Dec 2017 an EGD showed bile reflux, and then in April 2018 an EGD showed Barrett’s Esophagus and a hiatal hernia, which I never had before. Two different surgeons have recommended conversion to RNY to correct the reflux and to repair the hernia, so I will be having both of these procedures at the end of the month. I am also low normal BMI right now so I hope I don’t lose too much weight after surgery.

I’m looking forward to being free of all symptoms and resolution of pre-cancerous cells!

Good luck to you! But know that you are taking charge of your health to get rid of acid reflux!!!

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On 5/25/2018 at 3:37 PM, TexanGal said:

I was preparing for the gastric sleeve when my pre-op EGD scope showed I have Barrett's esophagus.

they all said the bypass was the best bet to cure GERD. And insurance approved it, even though I’m at 34 BMI. That alone says a lot, since they denied me for the sleeve even with comorbidities because I was too low a BMI.

The exact same thing happened to me and my surgeon and the insurance company made the decision for me. Well not exactly, my surgeon strongly recommended bypass and not sleeve, and my insurance refused to pay for anything but bypass surgery. Very glad it actually went that way as I think I will not have GERD to deal with again and my other health issues have resolved.

The 2nd quote was also the same for me and I was insurance approved for Gastric Bypass only even though my BMI was 34 at time of final approval. Good Luck! It is not always easy, but very much worth all the work.

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I am glad conversion has worked for so many people and I thought it would for me as well. However I am in complete and utter dispair because it has not helped my reflux at all. I am in constant pain 24/7. I don't smoke, drink, consume any caffeine whatssoever, etc. I'm pretty sure if I ate something spicy or greasy I would literally and instantaneously die of the pain. I understand I'm in the minority and would beg anyone who has reflux to choose bypass over sleeve because at this point death seems like a better option.

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1 hour ago, animallover1247 said:

I am glad conversion has worked for so many people and I thought it would for me as well. However I am in complete and utter dispair because it has not helped my reflux at all. I am in constant pain 24/7. I don't smoke, drink, consume any caffeine whatssoever, etc. I'm pretty sure if I ate something spicy or greasy I would literally and instantaneously die of the pain. I understand I'm in the minority and would beg anyone who has reflux to choose bypass over sleeve because at this point death seems like a better option.

I’m confused, did you have a revision from VSG to RNY and still have reflux or did you just have a VSG? I’m so sorry you’re still struggling with GERD. Are you working with a top notch Gastroenterologist to figure it out, have you had a recent EGD to see what may be the root cause, and are you taking any PPIs?

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2 hours ago, MarinaGirl said:

I’m confused, did you have a revision from VSG to RNY and still have reflux or did you just have a VSG? I’m so sorry you’re still struggling with GERD. Are you working with a top notch Gastroenterologist to figure it out, have you had a recent EGD to see what may be the root cause, and are you taking any PPIs?

Yes I had a sleeve Feb 2016 and revised to bypass. And yes, I'm still having reflux 24/7. One may ask how that's possible but I assure them it is. It actually feels like I didn't even have bypass at all. In fact I complained about reflux before I even left the hospital!!!! When I had nothing to eat!! I am currently waiting on my bravo testing and manometry testing. I am on dexilant 60mg, carafate, and zantac. I just don't understand! 😥 It can't be my diet because I'm not eating anything. Still on stage 2

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On 7/11/2018 at 1:15 AM, animallover1247 said:

Yes I had a sleeve Feb 2016 and revised to bypass. And yes, I'm still having reflux 24/7. One may ask how that's possible but I assure them it is. It actually feels like I didn't even have bypass at all. In fact I complained about reflux before I even left the hospital!!!! When I had nothing to eat!! I am currently waiting on my bravo testing and manometry testing. I am on dexilant 60mg, carafate, and zantac. I just don't understand! 😥 It can't be my diet because I'm not eating anything. Still on stage 2

Wondering if things got better for you ?

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Just to update all: I have never had GRD since my bypass. Hope everyone else is ok!

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20 minutes ago, Tracyringo said:

Wondering if things got better for you ?

No but I finally found out what the problem is. I had to go to the Cleveland Clinic to find out my weight loss surgeon was an idiot. Long story short he did a surgery on me called a heller myotomy 1 out of 6) and it cut the valve so its wide open so theres nothing to prevent the reflux from coming up. Cleveland said there's no treatment for the valve. My acid level was tested again it is over 3 times what it should be. I'll have to live with the constant reflux for the rest of my life. So..my reflux is nothing to do with bypass not helping me.

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On 3/1/2020 at 8:38 PM, animallover1247 said:

No but I finally found out what the problem is. I had to go to the Cleveland Clinic to find out my weight loss surgeon was an idiot. Long story short he did a surgery on me called a heller myotomy 1 out of 6) and it cut the valve so its wide open so theres nothing to prevent the reflux from coming up. Cleveland said there's no treatment for the valve. My acid level was tested again it is over 3 times what it should be. I'll have to live with the constant reflux for the rest of my life. So..my reflux is nothing to do with bypass not helping me.

So sorry to hear this. Wonder how often this happens?

I am having the bravo test done the 10th. I cant do the whole 7 days without my Dexilant. I have only slept 3 hours. Did you have to go a week without meds for your bravo testing ?

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Posted (edited)

Yes I had to go without the PPI when I did my 2nd bravo test. Do you have the sleeve? I ask because when I had to go without my dexilant for two weeks, I was expecting my reflux didn't worsen but it didnt. Do you know why? Because bypass patients shouldn't take extended release meds. Dexilant is an ER medication. ER meds won't hurt a patient, they just offer little to no benefit because by the time the medine is released, its already been digested.

Please let me know what your Demeester score is. Make sure to ask your doctor because this will give you an idea of how severe your reflux is. A normal score is 14.72 or below. Mine was 84.4.

Edited by animallover1247
Typos

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1 hour ago, Tracyringo said:

I am having the bravo test done the 10th. I cant do the whole 7 days without my Dexilant. I have only slept 3 hours.

So sorry you're still suffering from reflux this much. Did they offer you any other therapy option by now despite converting to RNY?

May I ask why you're doing this test? I thought it was already clear that you have severe acidic reflux?

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