I’m still in the pre-op phase of surgery. I have been planning for RNY vs. VSG because they did see reflux on my scope. I don’t take a daily med now, it is controlled by my food choices and if I do have it a simple Pepcid helps. In planning with the new surgeon he said as long as no hiatal hernia I could either.
My question is: I know they give reflux meds/PPI’s after surgery to protect against ulcers etc. how long have you had to take those prophylacticially and when can you stop them? I don’t want to be on them chronically since I’m not now. This makes me wonder if VSG might be better if I could not take them forever, but then again risk to make reflux worse could make that happen anyway!?‍♀️Thanks!

my clinic had us take them for a year (both the RNY and VSG patients), but that was seven years ago, before the not-so-great news came out about PPIs. I think most surgeons (including my clinic) have people on them for 3-6 months now.

You're much more likely to develop post-surgery GERD with VSG than you are RNY. About 30% of VSG patients have GERD issues after surgery (some of whom never had it before surgery), whereas RNY often improves if not outright cures GERD. That's the main reason that patients who had reflux issues prior to surgery are often told to consider RNY. I had some reflux issues before surgery, so my surgeon suggested I at least *consider* RNY, although he said he'd do either surgery. Some people are willing to take the risk because 70% of people do NOT have reflux issues after VSG, but I wasn't willing to take the risk.

I was the same. I controlled my reflux by my food choices & the very occasional Nexium (usually if I had too many champagnes or G&Ts - the carbonation).

I had a sleeve because the reflux wasn’t bad & I successfully managed it. I still watch my dietary choices but I do have reflux most days but it manifests itself differently now (hiccups not as severe, no bad taste in my mouth but burning in the throat most nights). I take Nexium every day which generally manages it & I was told I’ll always need to take one. I get not wanting to take meds all the time. I hate when I have to take any more than my one Nexium in the AM & my HRT in the PM. Was so glad I could toss the multivitamins from maintenance.

Whether you will need to take a PPI for a short time or forever will really depend on your physiology. It is certainly worth another conversation with your surgeon.

My surgeon says 6 months fwiw. I don't and never have had reflux. The PPI advice is standard for my surgeon.

Edited February 8, 20224 yr by Guest

For me it’s forever ?

I had a RNY to correct a failed (12 years old) surgery to fix my hiatal hernia. Before RNY my esophagus was L-shaped and half of Diaphragm was above where it.
Lately I have also been having to take Pepcid to control the reflux. I need to find a new bariatric Doctor Who can monitor me. Because of the reason that I had the bypass my surgeon was not a bariatric doctor he actually told me to get all of my information about the surgery and what needs to be done after in my lifestyle changes from the Internet I also need to find a Gastrologist because pills are getting hot when I swallow them just like they did before the bypass. I think my esophagus needs to be stretched again.
I’m very sad about all of this because I was told that by having the bypass it would fix all of my problems permanently. Losing 70 pounds was a big plus out of it!

Thanks for the replies! I know I’m the grand scheme of thing it’s not the biggest deal, but the longer time goes I become more on the fence with what procedure to do. This reflux issue is a big part of it

5 hours ago, mrsjo said:

Thanks for the replies! I know I’m the grand scheme of thing it’s not the biggest deal, but the longer time goes I become more on the fence with what procedure to do. This reflux issue is a big part of it

I don't want to tell you what to do, but if you're afraid of reflux, I'd strongly consider the RNY.

Pre-op I had reflux for years but it resolved any time I lost a significant amount of weight. I used to take Ranitidine as required, and more recently Omeprazole. I definitely considered bypass rather than sleeve, and my surgeon talked me through the pros and cons of both, but in the end I gambled on weight loss curing it again, and it has. If he had nudged me towards bypass I would have done that though.

My regime is 3 months of PPI after surgery so I'll be stopping it in another week or so. I know or at least strongly suspect I'll be fine without it.

I had GERD since 2010 and took omeprazole daily. 2016 I got the sleeve, didn't affect the GERD one way or the other. 2021 revised to bypass and my Doctor had me take the meds for 30 days post-surgery and then stop - my side-effects after I stopped and the GERD is gone.

It would be dependent on your individual issues. I had bad GERD pre-surgery with a hiatal hernia. Post surgery and H-hernia repair, and I went briefly off pantoprazole after a month. While I had no sign of reflux, I instead developed an ulcer at the stoma within two weeks and was put back on pantoprazole for the next 6 months. I'm still getting the occasional pain in the region of my stomach/intestine join, so I will not be surprised if my surgeon keeps me on the drug for longer than that.

Having been on Nexium for 15 years, I won't blink if I'm on Salpraz for a few more.

On 02/08/2022 at 21:48, Smanky said:

It would be dependent on your individual issues. I had bad GERD pre-surgery with a hiatal hernia. Post surgery and H-hernia repair, and I went briefly off pantoprazole after a month. While I had no sign of reflux, I instead developed an ulcer at the stoma within two weeks and was put back on pantoprazole for the next 6 months. I'm still getting the occasional pain in the region of my stomach/intestine join, so I will not be surprised if my surgeon keeps me on the drug for longer than that.

Having been on Nexium for 15 years, I won't blink if I'm on Salpraz for a few more.

Did you have the RNY? The ulcer thing near the stoma is what worries me with the RNY. The advantage of the pyloric valve left in the sleeve is what makes me think that’s better, but for reflux not at all. So much decisions

If the prescribe them to sleeve patients too not everyone does this. I didn’t have to take them post surgery even for a short time. They always ask about reflux at post ops but I haven’t had any issues.

6 hours ago, mrsjo said:

Did you have the RNY? The ulcer thing near the stoma is what worries me with the RNY. The advantage of the pyloric valve left in the sleeve is what makes me think that’s better, but for reflux not at all. So much decisions

I had a Mini Gastric Bypass/Omega Loop.

Oh Smanky that sounds awful! My doc said I need to have another endoscopy to get the all clear for no gerd meds. I had H- repair too. I won’t know until next month.