Bile reflux

[Secondtimelucky 2]

I had a VSG in 2008. I’ve been on nexium for acid reflux since then. At my lowest, I’d lost 120 lbs. I’ve kept 50 of that off. In addition to weight creeping back up, I’ve continually had problems with burping, hiccups, occasional vomiting, pills getting stuck, and bile washing back up. Finally, I went back to my surgeon late last year. I wasn’t planning to do another WLS (I’m 55 and thinking this is just how I am), but did a barium swallow and endoscopy. He said I have bile reflux (in addition to acid reflux) and that puts me at risk for esophagal cancer. He wants to do a gastric bypass and I’m scheduled for that now.

The whole cancer risk scare is what is driving me, but I have mixed feelings about the surgery. I’m certainly hoping that it clears up both the acid and bile reflux issues, but halfway through my pre-op, I’m feeling pretty down about the whole thing. Anyone else go through this? Thanks

[Cherylanne22 27]

I have Gerd and am really worried about it getting worse, surgery is 4/15?

[Tracyringo 503]

I didnt want to have revision either. I still miss the restriction of the sleeve and I still have GERD and am on the same PPI I was on with VSG. I will be a year out from revision in May. I will say though the reflux is better and it appears the revision helped in the fact I went from esophagitis D to A, no barrets and cancer for me !!!

I also lost more weight and have gotten to my lowest and its much easier so far to maintain then the sleeve. Good luck to you!!

[catwoman7 10,860]

unfortunately, GERD does happen to about 30% of VSG patients - and revisions for severe GERD aren't uncommon. RNY usually (but not always...) will improve it if not cure it.

I would certainly do the bypass vs risk getting esophageal cancer, but then, I'm not you. Hopefully you'll get a lot of responses here from people who've revised for that reason - there are several folks out there..

[mae7365 372]

RNY cured my GERD, Gastritis and Esophagitis. Not on reflux episode since surgery in October 2020. I had the sleeve in 2014.

[Auriele 1]

I had an endoscopy done revealing bile reflux 3 years post VSG. I can say it was absolutely miserable I really couldn’t do anything without basically throwing up a little. I had issues with grazing so I opted for a DS instead of a Bypass but it instantly fixed the problem for me and I am so much happier. Typically a DS does not help with reflux but in my case it did and I feel like a person again. I would get the bypass.

[Secondtimelucky 2]

Thanks everyone for the replies. Mentally, I think I’m getting there.

[RickM 1,747]

On 3/28/2021 at 3:51 PM, Auriele said:

I had an endoscopy done revealing bile reflux 3 years post VSG. I can say it was absolutely miserable I really couldn’t do anything without basically throwing up a little. I had issues with grazing so I opted for a DS instead of a Bypass but it instantly fixed the problem for me and I am so much happier. Typically a DS does not help with reflux but in my case it did and I feel like a person again. I would get the bypass.

The DS is certainly the preferred solution for bile reflux problems - it's about a sure a fix as you can find. assuming that you have a surgeon who knows how to do it. Looking at the anatomy, and you see that bile has to go many feet down the inactive (non food) channel before it gets to the common channel where it and the pancreatic enzymes, mix with the food, and it would have to move many feet back upstream against the food flow to reflux into the stomach. The bypass is a less certain fix as the pyloric valve has been removed and the pouch moved just downstream of the bile ducts, but it usually isn't a problem if they make the roux limb long enough (sometimes in non-WLS variants of the procedure where they make the limbs shorter to minimize weight loss, bile reflux is a real problem.)

As the DS uses the same sleeve that you started with, or maybe a resleeved version, it doesn't usually help with acid reflux, unless the original sleeve was poorly made (it happens, though not too often with a DS surgeon who knows how to make their sleeves.) Virgin DS's tend to be somewhat better on this than the VSG as they usually use a larger sleeve that is less prone to reflux problems.

In short, you got the best procedure available for your bile problem - be happy.

[Arabesque 6,471]

On 3/28/2021 at 5:25 PM, Cherylanne22 said:

I have Gerd and am really worried about it getting worse, surgery is 4/15?

I had stress & diet related reflux for years before surgery & overproduced acid to complicate it more. I also can’t burp so that added to the fun. I had changed a lot of my diet to avoid stimulating the production & to not aggravate it over the years. I took Nexium only as needed. Post surgery my reflux is different. I take Nexium every day. I get more throat burning than before if I forget my Nexium or eat hard Protein before bed. No bad taste in my mouth anymore. No strong cutting pain across my abdomen if I had too much acid in my tummy. (They thought I had stomach ulcers but no.) And my hiccups are way better. (They used to be horrendous. Painful at the time, sometimes causing vomiting & then painfully sore muscles the next day.) So the sleeve surgery has helped a lot & while I still have reflux it’s easily managed.