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Gastric or Sleeve which is better?



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Hello All! I am trying to figure out which tool would be better for me. I have Gerd and can't even drink Water without getting heartburn. I have been over weight my whole life and want to get the best tool possible to help me not only lose the weight but to keep it off. I have 1 shot and only 1 shot at this and I want to get it right. Any information anyone would like to share would be very much appreciated!☺️

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Let me preface this by saying that this conversation is better handled between you and your doctor.

To answer your question about which is better, that's entirely based on individual situation.

There is some evidence to suggest that the sleeve can make pre-existing GERD worse. However, there's also some evidence that this link is negligible. Regardless, you will find some doctors who refuse to sleeve a patient with pre-existing GERD. You will also find sleeved patients who develop GERD being revised to RNY to treat the GERD.

I can only speak from my personal experience. I had GERD before I was sleeved. I had it with lap band and off/on after I had the lap band removed. For personal reasons, I did not want to even consider RNY. So, I had a frank discussion with my doctor about the likelihood of GERD after sleeve. He felt that my GERD was "situational", meaning that my lifestyle and state of obesity contributed to it and its exacerbation. He and I were willing to take the chance of post-sleeve GERD and so we proceeded.

About 6 weeks after my sleeve surgery, I started having heartburn. We immediately implemented PPI's (Nexium), which took care of the heartburn and I thought I was in the clear. Life was good as long as I took my Nexium. About 6 months after surgery, I started noticing that I'd wake up with sore throat like I'd had a runny nose all night. If I ate too late, I'd be awakened by reflux (not choking or anything, but I could feel the stomach contents moving up towards my throat. Gross, I know, but it's the honest truth). I tried all of the GERD recommendations (no eating after 7, avoid certain foods, sleep with head elevated) and some not so common ones like DGL, sea buckthorn, and something called "Swedish Bitters". Everything helped, but didn't really solve the issue. I'm now seeing a gastroenterologist and we'll see where that takes me.

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I have to say that my decision was made by the fact that I had horrible GERD already so I wasn’t going to risk that being possibly even worse with the sleeve. Combine that with the number of people going back to have the sleeve to bypass conversion and my decision was made. My Dr. gave me all the pros and cons of both surgeries and gave me a recommendation, but ultimately the decision was mine.

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Thank you both Ladies . I greatly appreciate it. I am just starting the process and my Doctor actually suggested that I speak to people who have actually had these procedures done and see what their experiences have been just so I can say that I have truly investigated and done my research before I make my decision.So thank you so much again for sharing your experiences and information its very helpful.😊

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I've heard from numerous people that RNY is the best most efficient surgery

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I had horrible GERD after getting the sleeve. Never had it before. Had bypass in December and it is so much better, even the recovery was easier than the sleeve.

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Thank you so much for your input,it helps a lot and is very much appreciated !

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I had bad GERD before surgery - so bad that once on vacation I went and slept in the truck so I could be upright all night (that was after Mardi gras in NOLA and then some late night spicy gumbo and red wine aka trifecta). I would commonly wake up 1-1.5 hours after falling asleep with stomach acid in my throat which was one of the worst feelings and good luck going back to sleep after that, regardless of when or what I ate. My insurance would only cover RNY and interestingly first meeting with my surgeon he suggested the sleeve, so my decision was purely insurance based. I can say that post op I haven't experienced the slightest amount of reflux and I've gone down from 2x's a day 100 mg of Omeprazole to 20 mg of famotidine 2x's day. It does seem that there are quite a few posts on here about conversion from sleeve to RNY due to GERD but there also seems to be way more posts in general about sleeve patients so I take that stat with a grain of salt without some concrete analysis behind it.

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I know exactly how you feel. I sit up most nights to sleep and it doesn't matter what I take I'm up at least 3 times a night. I can drink Water and eat nothing at all and still have horrible acid reflux. So it is very encouraging to know that with either procedure there is a good possibility that I might one day get to sleep more than two hours at a time and actually get to lay down...lol Thank you for your input!...😁

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Wow, ur Gerd sounds horrible ! I had gerd so bad I lost my voice at one point . I had a BMI if 35 and did the sleeve and am now about a 30 BMI . I took lansaprozole before surgery and am continuing to do so . Haven’t noticed GERD any worse since surgery . I had a hiatal hernia fixed during surgery so hope that once I am at goal , reflux should disappear . Nonetheless I don’t drink or eat chocolate and those were the things that really made the Gerd worse

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Forgot to add that I had a hiatal hernia as well. My gastro doc told me that fixing it was a 50/50 on fixing the gerd issue.

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I just had the test done Monday and they found that I hiatal hernia and am hoping that which ever tool I deside to use they will fix it while they are in there...lol Not Fun...

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