I had the sleeve and took omeprazole for about a year post op. I went off and had a great 3 years. This last year the pain of reflux and spasm has gone from mild to moderate to I am crying at 1 am unable to sleep. I kept my weight off (125 pounds) for 4 years but this last year I have regained about 15 or so. Is my weight gain the cause? I admit I was religiously off diet soda the first year or so but have slowly started drinking them again. Is it the soda? This last week has been unbearable. Should I try gaviscon or nexium? I have maintained my small meal small portion control. I blame weight gain to Covid, isolation, no gym and a sudden love of sandwiches (bread). Tho I eat a small half portion - is the bread doing more than weight gain?

I doubt the weight gain is directly responsible for your misery, but I'm not a doctor. I would recommend you contact a doctor. If it were me, I'd consult a gastroenterologist.

Theories on your current situation:

1. Theory #1: You may have long-term, silent reflux. After a while, it sort of erodes the lining of your stomach and causes an ulcer.
2. Theory #2: The changes in your diet may be contributing to an exacerbation of your reflux.
   • If you have reintroduced diet sodas, are they caffeinated? Caffeine can contribute to acid reflux (as per my doctor).
   • The gluten in bread is more challenging to digest. Not to say you're gluten intolerant, it's just the nature of the beast. If you're eating too late into the evening/too soon before bedtime, you may have residual undigested food that's sort of "laying there" and causing your discomfort.
3. Theory #3: The extra weight MIGHT be causing additional pressure on your diaphragm at night and contributing, but is unlikely a primary cause.
4. Theory #4: A combination of theories 1-3.

Long-term, untreated GERD can have lasting consequences. Please consult a doctor. In the meantime, if it were me, I'd implement standard GERD strategies: PPIs (prilosec/nexium), make changes in my diet to avoid foods that contribute, sleep on a wedge/inclined bed, do not eat 3 hours before bedtime, etc. Good luck!