Heartburn Questions

[SunnyinSC 137]

So I had my consultation with my surgeon on Monday. Based on my own research I had thought gastric bypass was the best option for me. However my surgeon said that at my weight (I'm currently 265lbs at 5'3.5") and given my heartburn/acid reflux isn't bad enough to warrant daily medication, he feels like a sleeve would be the better option because there is less risk involved and the weight loss expected would be about the same. I now have an endoscopy scheduled for later this month so they can see if there is a hernia in play, and check damage/issues with my esophagus to confirm my issues aren't severe. This was thanks to the nurse, who was sort of advocating on my behalf for double checking the issues weren't severe. After the endoscopy we'll make a decision on bypass or sleeve then. I'm self pay though, so I'm really nervous that we'll go with sleeve and then my heartburn issues will get worse and I'll need a revision (which I'll also have to pay out of pocket for).

So I wanted to check with some folks that have had the surgery about heartburn after. Currently I get heartburn/acid reflux 3-4 times a week and I medicate with tums/milk. It started when I was pregnant and didn't ever go away (even though I lost some weight while pregnant). Usually issues happen if I eat too close to bedtime, eat too much at dinner, or eat acidic foods. Sometimes it's bad enough that I'll wake up coughing in the middle of the night, feeling like I have stomach acid in my lungs (this is when I attempt to drink some milk to get the throat burning to calm down, not that it works well). If you have had similar heartburn prior to surgery, and went with the sleeve surgery, did the issues worsen? Did they get better with weight loss (my surgeon suspects it's a weight issue and will go away after the weight is gone)? Am I being reasonable in my concern or should I just listen to the surgeons recommendations regarding which surgery to get and keep my own fears out of the decision?

[chiquitatummy 327]

I'm close to your height and started out around the same weight (5' 2" HW of 271) and had some heartburn before I started my program. My symptoms were milder than yours (lots of discomfort after eating, able to tough it out without tums, but miserable for hours after eating). I found that when I lost some weight pre-surgery it mostly went away. May have been self-inflicted pain from my habit of eating too much and too fast.

I did have an endoscopy and menonotry done which was enough information to make my Dr. comfortable with VSG for me. He waved the 24 hour PH study for me, but that is normally part of tests my program does to ensure someone with GERD symptoms is a VSG candidate. Turned out that while I had a little bit of stretching in my esophageal sphincter everything looked great and I was given the green light for VSG. I'm 1 week out from surgery now and feeling really good. Part of my program's protocol includes putting VSG patients on omeprazole for the first few months which is supposed to help tame the stomach acid while your healing and eating very little. You might ask if this is something that your program does.

All that said, I really understand hesitating. The prospect of GERD misery getting worse with surgery is scary. My understanding from my program is that the results of the menometry, PH study, and endoscopy are pretty reliable in determining if someone is not a good VSG candidate because of current GERD, but that there is also a chance that anyone could develop GERD with VSG, so there is some gamble for everyone. Weighting the % risk of this vs. that was one of the hardest parts of making my surgery decision. It took me 2.5 years from beginning to consider the option of WLS to signing the papers to confirm that I made the decision. I am only a week out, but so far I am really glad I did it and none of my worst fears have happened.

Good luck!

[blackcatsandbaddecisions 845]

I had heartburn prior to surgery- generally I had it about 1x a day, sometimes more or less. I always controlled with Tums. I have been on 20 mg of Pepcid since I had surgery in early November and *knock on wood* I haven’t had to have a tums since. I am not sure if it is the Diet change or the weight loss or just the Pepcid, but it has been a welcome change. I’m honesty kind of concerned about tapering off the Pepcid in case it’s that because this is the longest stretch I think I’ve had in years without heartburn.

So, so far so good from my perspective.

[SunnyinSC 137]

Thank you for the responses. The surgeon did casually throw out that if I develop GERD I can be put on a prescription for it, but I wasn't a huge fan of that attitude. Part of the reason for getting the surgery is to get off the medications I'm on that are related to issues caused by obesity. So the thought of having to put on something new due to the surgery when I was really hoping the heartburn would go away was a bit of a downer. I'll try to get my anxiety over it in line and just wait to see what the Endoscopy says. The surgeon I have has been doing this a long while now, so I should probably listen to him. It's just the self pay and thought of needing revision for GERD later that is giving me the ickies.

Edited March 4, 2021 by SunnyinSC

[kim0221 4]

I've had bad heartburn for years. Same frequency as you but probably more severe because no amount of tums would alleviate it. I needed PPIs for a while, then when the script ran out, I thought I would be fine, but it came back again 3-4 x per week but bad enough to cause severe chest pain.

I had the same concerns as you regarding sleeve. My endoscopy was normal.

Since my heartburn was controllable with daily PPIs pre-op, I went ahead with sleeve hoping for same response to PPIs post-sleeve.

I'm about 7 weeks post-sleeve now and on daily PPIs (I'm on once daily only, which is standard but could be increased to twice daily for some).

So far, I've had mild heartburn about 3 times, always after meals, and I think all were related to me missing a PPI dose!

I haven't lost nearly enough weight yet to say that my heartburn is better due to weight loss post-op. So I attribute the almost absence of problems with heartburn to the daily PPI.

I would have thought twice about the sleeve if my pre-op heartburn was not responsive to PPIs.

But for me, since I was PPI-responsive pre-sleeve, it seems my symptoms are PPI-responsive post-sleeve.