I want a VGS & am being told that Bypass is better because I get occasional heartburn. I know my triggers & think if I stay away from them I can make VGS work.

I'm Trying to weigh out my options & would Greatly accept any and all advice & input.

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I want a VGS & am being told that Bypass is better because I get occasional heartburn. I know my triggers & think if I stay away from them I can make VGS work.
I'm Trying to weigh out my options & would Greatly accept any and all advice & input.

Also, surgery date is tentatively set for July 17..

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They're likely concerned that since you already have issues with heartburn and thus stomach acid that the VSG would make it worse. Some 30% of people who have VSG end up having acid issue and many end up having to get revisions to a Gastric Bypass. But then the other 70% either have no difference or nothing significant changes. I have acid issues from my EoE so my gastroenterologist was pushing for the Bypass, but it was MY decision in the end and I went for the Loop Duodenal Switch which has a VSG stomach (just with the intestinal malabsorption bit added) and my acid issues hasn't got any worse. In fact, I believe it's slightly better than it was. So just weigh the pro's and con's and choose whatever makes YOU happy because it's your life and YOUR choice in the end because you are the one that will have to live with it. Not your doctor or anyone else.

I had occasional bad acid reflux and my surgeon pushed heavily for bypass vs VSG. I did my research and felt that bypass was not the choice for me with the malabsorption and others experiences I’ve read/heard about. Turns out I had a hiatal hernia that they repaired while in for my VSG and it may have been the cause. I’ve had zero acid reflux or heartburn since surgery and I’m 11weeks out. Even spicy foods don’t bother me.

I had acid, but learned during my pre-surgical endoscope that it was due to a HUGE hiatal hernia. Doc fixed the hernia when we did my sleeve and I have had no acid since (three and a half years)

as someone else said, heartburn/reflux tends to get worse in about 30% of VSG patients. Which means it doesn't in 70% of patients. So it comes down to whether or not you're willing to take that risk. I wasn't willing to take the risk, so I went with bypass. But you may be different.

When you pick a doctor, definately ask about their experiences with patients having acid issues after sleeve. How often does it happen to their patients? What treatments do they pursue? How many of them need surgical revision? Some doctors will have a better handle on this than others. Also ask...how have you modified your technique to avoid acid issues with sleeve? Do you have fewer patients with post surgical acid issues now? Have you done any recent continuing education on patients who experience acid with sleeve? Go to someone who is part of the conversation for the newest ideas in surgery. It's not a guarantee you won't have problems, but it increases your odds for success.

I did my EGD & found out I have a diaphragmatic hernia. Makes me wonder if it's got anything to do with my heartburn?....

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2 hours ago, Creekimp13 said:

When you pick a doctor, definately ask about their experiences with patients having acid issues after sleeve. How often does it happen to their patients? What treatments do they pursue? How many of them need surgical revision? Some doctors will have a better handle on this than others. Also ask...how have you modified your technique to avoid acid issues with sleeve? Do you have fewer patients with post surgical acid issues now? Have you done any recent continuing education on patients who experience acid with sleeve? Go to someone who is part of the conversation for the newest ideas in surgery. It's not a guarantee you won't have problems, but it increases your odds for success.

Absolutely. When I had my VSG ten years ago, most bariatric surgeons were just learning how to do them - while they are in concept simple and straightforward to perform, like anything else technical, there are subtleties and techniques in doing them correctly - "twenty years of doing bypasses and they think they know how to do a sleeve..." was the refrain from one prominent surgeon at the time. While the sleeve does have some predisposition toward GERD (much like the RNY is predisposed toward dumping, reactive hypoglycemia and marginal ulcers,) this was compounded in the early days by surgeons who hadn't yet figured out the technique to consistently get them right to minimize that predisposition, and to some extent continues today in areas that were slower to adopt the sleeve and are behind the learning curve. This is a good part of the reason that I travelled 400 miles to a practice that had been doing them for twenty years (at that time) rather than a local practice that had been doing something else for twenty years.

2 hours ago, wlh75 said:

I did my EGD & found out I have a diaphragmatic hernia. Makes me wonder if it's got anything to do with my heartburn?....

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Talk to your doctor on interpreting this. Hiatal hernias are common with morbidly obese people, and a common cause of heartburn. They can easily be fixed during the WLS procedure, so if that is the cause of your heartburn, things look better for you. A hiatal hernia can be described as a diaphragmatic hernia, but not all diaphragmatic hernias are necessarily a hiatal hernia - so get some clarification on that.

14 hours ago, wlh75 said:

I want a VGS & am being told that Bypass is better because I get occasional heartburn. I know my triggers & think if I stay away from them I can make VGS work.

I'm Trying to weigh out my options & would Greatly accept any and all advice & input.

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I had sleeve surgery ten years ago. I have an appointment with a bariatric surgeon because of severe GERD and I have a hiatal hernia. I am on a prescription PPI AND eating Tums!!! I would recommend the RNY for sure.