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Gastric Sleeve and GERD



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Hi! I am just beginning my weight loss journey, but have been doing research and have decided that I would like to do the gastric sleeve surgery. However, I have a friend who told me I may not be a candidate for it because I have GERD and severe esophagitis. I believe my GERD is caused by the medium sized hiatal hernia I have and was hoping the surgeon may fix that during my WLS procedure. Is that something the surgeon may do? Anyone have a surgeon approve the gastric sleeve surgery, even though you have GERD? I am hoping to avoid gastric by-pass because of the absorption issues that can occur. Thanks!

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48 minutes ago, Zoomzoom said:

I had GERD and a large hiatal hernia. I had the sleeve and hernia repair at the same time. My doctor was not concerned about the GERD as it was due to the hernia. I've had no problems since, but I am only 3 months out.

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Thank you! I am hoping my doctor will not be too concerned with it either.

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From my experience, it's a little hit or miss. I think it also has a lot to do with your surgeon and his/her approach

I had a friend who was really encouraging me to get the sleeve. She had a lap band and developed Barrett's esophagus. She got the sleeve and has had no GERD. Her esophageal issues resolved.

I had a history of GERD, also had been banded. Doctors warned me that I may develop GERD after the sleeve. However, we discussed it because like you, I did not want the malabsorptive aspects of RNY. After some testing, we came to the conclusion that my GERD was "situational" meaning that a combination of things were contributing to it: my weight, a small hiatal hernia, overall dietary choices, etc. I went through with the sleeve. About 6 weeks in, I started getting heartburn that eventually advanced to nighttime reflux. It's been easily controlled with Nexium and some minor lifestyle changes like not eating 3 hours before bedtime and sleeping on a wedge. HOWEVER, I do get "flare-ups" of esophagitis and have to take Carafate when it happens.

Other than the occasional esophagitis, I have no long term or lasting consequences of GERD. My GI doctor and I are currently looking into a stretta procedure to thicken the lower esophageal sphincter.

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most surgeons will recommend bypass if you've had issues with GERD. It will get worse with the sleeve about 30% of the time - so whether or not it will for you is kind of a crap shoot. I had GERD and was warned - so I went with bypass. I did not want to risk it getting any worse.

your surgeon will advise you on which way he/she thinks you should go based on your specific health conditions, but I don't think most would refuse to do surgery A or surgery B if you were insisting on it. But I would be careful with the GERD factor. I've been on this and other bariatric forums for several years and have seen a lot of people have to revise due to GERD. It may not happen to you - but there's no way to know that ahead of time.

also, malabsorption typically isn't a problem if you stay on top of your supplements. You'll have to take supplements with the sleeve as well.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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