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Why do so many sleevers get GERD?



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Hi Folks, been scouring the posts and it seems like most sleevers get GERD, which is disconcerting but I know it's preferable to being overweight. Are you getting GERD because your surgeon made your sleeve too small? I'm specifically asking if you didn't have GERD before. Thinking I might just switch my surgery to the bypass to avoid this. I still don't know which procedure to get...ARGH

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Posted (edited)

Most sleevers don't get GERD if they didn't have it before - it just seems that way because people don't really post the positive - you're FAR more likely to see a post about getting GERD than a post about not having a side effect/complication. According to some studies, about 9% of people who are sleeeved get GERD (the title in the link to this article is a bit misleading: https://www.mdedge.com/gihepnews/article/80250/gastroenterology/sleeve-gastrectomy-often-worsens-gerd)

According to the article: "Most LSG patients [who had GERD before surgery] (84.1%) had persistent GERD symptoms after the procedure; only 15.9% reported resolution of symptoms. An additional 9.0% of LSG patients reported postoperative worsening of GERD symptoms. And 8.6% of patients who didn’t have GERD before undergoing sleeve gastrectomy developed the disorder afterward."

So, if you don't have GERD now, this study would say you have an 8.6% chance of getting it afterwards. Most of the people I've met who have had the sleeve have no GERD (and one bypass patient I know does). And the few sleevers I know who do have GERD have it well under control with medicaiton.

In the end, read the studies. Talk to your surgeon. Have you had an endoscopy - talk to your surgeon about the results and what s/he thinks it means for the likeliness of getting GERD.

As to why - my understanding is that because you're stomach basically becomes a tube, the pressure in your stomach increases, which increases the chance of the acid being forced back into the esophagus. This is a really nerdy article, but Table 1 talks about why obese people in general have a higher incidence of GERD, why someone might newly get GERD after sleeve (de novo column), or why GERD might get better after sleeve ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579881/

NOTE going into the next paragraph - my experience is NOT typical. I know some on this board would prefer that people don't talk about their bad outcomes, but I feel like people should know that a small number of patients do get the. I'd also say that, for me, some presentations of GERD are not preferable to being overweight. Unfortunately, my surgeon gave me the 8.6% figure as ALL sleeve patients - he didn't give me the #s on people who had GERD before (I recognize I should have done more of my own research - I did some, but somehow didn't see the study linked to above). I had a bit of GERD that was very well controlled before surgery. I felt great for about 3 months post-surgery. Months 4-5 were so rough with GERD I could barely eat (I struggled to get 3-400 calories vs. eating about 700 in the few months after surgery) and struggled every waking moment not to throw up. It is better now (at 8 months), but I still have GERD and can tell you at any given time exactly where the acid is in my esophagus. I can tell you that at months 4-5, I would have 100% taken all the weight back to feel better. And even now I seriously regret the surgery and would trade the 125-ish lbs loss to feel like I did before surgery (edited to add - I also have other complications, so its not just the GERD that makes me regret this - but I likely would have had the other complications with RNY, too). But, for various personal reasons that really only apply to me, I wouldn't have had the RNY and still won't convert. So, I'm working on it in therapy because it is not mentally healthy to continually regret a decision I can't take back.

Edited by notmyname

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I didn’t have GERD/ acid reflux until after the sleeve. I ended up with 4 ulcers in my esophagus. I just had revision surgery to the gastric bypass on Monday.

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Posted (edited)

This was a concern of mine too. Especially on the Facebook bypass support groups I was on. They were saying that 25% of sleevers end up getting converted. Yikes! But you can’t believe everything you read on the internet and so I went looking for more reliable sources of information - namely medical studies. Sorry I didn’t save the links so you can read them for yourself but I have screenshots of the information I wanted:

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As you can see, the numbers are actually quite small! So don't feel you have to worry about getting a revision - statistics are in your favor!

Edited by KCgirl061

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I had bad GERD before surgery...all gone now and not taking PPI's anymore!! I try to not eat too much (my stomach tells me when it's time to stop) or right before bedtime, which are just common sense things.

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