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Sleeve or Bypass... help!

Hi, I have a VSG scheduled for December but I'm still in doubt if I should go for a bypass!

I'm 297lb -and 6.0 tall - BMI 39

I was sure about getting a VSG but my endoscopy exam has the following: light esophagitis / Barrett's Esophagus - GERD . To be honest I don't feel anything related to it but I read a lot of articles and comments that VSG is not good for who has reflux.

My doctor checked the exam and said would be ok proceed with VSG. I went to another doctor to get a second opinion, he saw my exame and right away said better get a bypass! Next week I will return to my doctor and talk again and might change to bypass.

What you guys think? Anyone had a similar experience?

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  • I have Barretts too. BMI 39 I went through extensive testing with gastroenterologist before being approved for WLS. My recommendation based on multiple physicians and medical universities, Gastric By

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Some sleevers manage to not worsen their Gerd, many do not. I had gastritis, Gerdn for those and other reasons I went with RNY. N9w I am one of the few who stenosis/strictured, despite what you see on here it is still rare, fixable, and giving 75% of my stomach away to the medical trash would have not been of benefit to me. Join me in Club Bypass, I had a 1st cousin die of esophageal cancer, it is a painful, not pretty way to go! 2 and half years and I still miss her so much!
Bypass definitely if you have GERD!

My surgery was completely uneventful and maximized weight loss with bypass. Other than gas pain it was well worth it!

Best of luck
  • Author
1 hour ago, Frustr8 said:

Some sleevers manage to not worsen their Gerd, many do not. I had gastritis, Gerdn for those and other reasons I went with RNY. N9w I am one of the few who stenosis/strictured, despite what you see on here it is still rare, fixable, and giving 75% of my stomach away to the medical trash would have not been of benefit to me. Join me in Club Bypass, I had a 1st cousin die of esophageal cancer, it is a painful, not pretty way to go! 2 and half years and I still miss her so much!

Thanks for your feedback and I will do consider what you said in my decision, glad you shared it.

  • Author
1 hour ago, BostonWLKC said:

Bypass definitely if you have GERD!

My surgery was completely uneventful and maximized weight loss with bypass. Other than gas pain it was well worth it!

Best of luck

Thanks for your feedback!

  • 2 weeks later...
  • Author

Thank you all, tomorrow I have scheduled a Esophageal motility study and Esophageal pH monitoring and according with the results my doctor and I will decide if sleeve or bypass, surgery scheduled for December 12th.

I have Barretts too. BMI 39 I went through extensive testing with gastroenterologist before being approved for WLS. My recommendation based on multiple physicians and medical universities, Gastric Bypass is the only way to go. Even with sleeve you run risk of continued or exacerbated GERD. With Bypass, my GERD is 100% cured. I used to take 4 nexium everyday. Now, zero. I also read a peer review paper on how with GBP there is a 33% chance of Barrets reversal. One other item to consider. If you ever have Barretts progress or issues, they cannot undo any WLS except Bypass. That was a key component to the choice too.

With GERD the sleeve is still an option although it's a it depends kind of situation.

With Barrets I have no idea why your physician wouldn't be basically forcing you to do the bypass. Barretts is no joke and I know the surgeons I work with wouldn't even consider a sleeve on somebody with it

I had occasional acid reflux/heartburn (no formal GERD diagnosis or anything) and bypass was the only viable option I was given (which was fine because that's what I wanted anyways). I personally would not risk making something like that worse after you go through all the trouble of having major surgery. Since the bypass 5 weeks ago, I haven't had an instance of reflux or heartburn once. It's amazing. Would never have considered sleeve and the surgeon was pretty adamant that sleeve is not a real option for anyone with reflux.

  • Author

Hey
I did a Esophageal motility study and results are:
Esophageal pH monitoring: normal, just had 8 refluxes in total, normal is less than 50.
esophageal manometry: hypotonic lower esophageal sphincter

I will get back and talk with surgeon on Monday to decide sleeve or bypass, by the exam looks like would be ok sleeve as pH monitoring is more important than manometry but not sure yet...

Anyone had a similar result? If so what you did sleeve or bypass?

Thanks

Edited by Alexandro

If there is any doubt why risk it. I would go with the procedure that has the lowest risk of reflux i.e RNY. Otherwise you are likely to be looking at having 2 surgeries not 1

  • Author

I just got back from the surgeon appt, he reviewed the ph monitoring(which showed 5 refluxes till almost my vocal cords) and manometry and we decided for bypass!!! Scared now! Surgery on Wed.

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