Hello
I have GERD and I know it's a risk with the gastric sleeve but, I was just wondering how do I avoid even more GERD issues after my gastric sleeve?

I just had a revision to RNY because my post sleeve GERD was so bad. I now have Barret's Esophagus so didn't want to put it off any longer.

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Unfortunately, if you have GERD, a gastric sleeve really isn’t for you. It is very likely your symptoms will get even worse & you could face developing Barret’s Esophagus like @ElyQuint (sorry this has happened to you).

In saying that I had acid reflux before my sleeve surgery which isn’t isn’t as severe as GERD. I managed it with diet & had only rare episodes - less than a handful of times a year (usually if stressed or if I made poor dietary choices - like too many champagnes or gin & tonics ?). I still have reflux post surgery but it manifests itself differently now. I still watch my food choices (no spicy food, low caffeine, rarely have carbonated drinks or let them go pretty flat, avoid rich & creamy foods). A daily esomeprazole in the morning generally manages it - sometimes have burning in my throat for an hour or two at night but that’s all. But again that’s reflux not GERD.

It really gets down to how bad your GERD (everybody gets occasional heartburn, that's just being human) and what is causing it. If it is caused be a hiatal hernia, which is quite common amongst obese people, then that will be fixed during your surgery. However, there can be other causes more specific to you that may not be fixed, in which case the RNY may be the better choice. If you haven't had one, I would suggest getting an EGD (endoscopy) to find out what's happening down there and guide you in your decisions. Some surgeons routinely order them pre-op, and others don't, but I think it's a good idea to answer questions like this.

Having a surgeon who is well experienced with doing sleeves (not just bariatrics) is also helpful, as it takes practice for them to consistently get the sleeve right. When I had mine done ten years ago, there were a lot of sloppy sleeves being done as that soon after the sleeve started being approved by US insurance and most surgeons were still working their way up the learning curve. That is less of a problem now (at least here in the States) as most surgeons here are well up that learning curve, but there are still newbies at is out there and they should be avoided, particularly if things are marginal in the reflux department.