Hi all. I've been lurking the past few weeks, researching heavily. My insurance has cleared me for sleeve but I'm not as sure now as I was when I chose that surgery. My last hurdle is labs and upper GI. I'm bouncing back and forth between sleeve and bypass. My doubts about the sleeve include the risk of developing GERD. I see a lot of revision stories and I don't want that.

My main reason for choosing the sleeve was to keep the pyloric valve intact and avoid dumping. It also seems to allow normal medication action - I take a number of meds. I'm creating a list of questions for my surgeon because I want to make the best choice but man, I must admit to feeling dizzy with all this information. It's a big step.

I'll save my dietary questions for another post. Thanks already for the great information I've gotten from reading through this forum!

Edited October 22, 20223 yr by David in Washington

2 minutes ago, David in Washington said:

Wow, now that's worth considering. I've had IBS since my teens. Thanks.

I just noticed your weight loss - 180lbs in 3 months? Wow, just wow.

Yeah I developed it in my teens too.

No I'm a revision due to... GERD. I had Lap Band first. Zero Yelp ⭐ Do Not Recommend.

I would be the incredible shrinking lady if I lost 180 pounds in 3 months, lol.

The sidebar stats here don't really give the opportunity to show that you've had revision, but you can see it if you click to read a persons profile... if they've updated their info.

2 hours ago, David in Washington said:

Wow, 30 pills! This does make me feel better. I'm still going to ask my surgeon and PCP, but I've been reading that Cox-1 specific NSAIDS liike Celebrex and Mobic are ok for regular use. I'm on Mobic (meloxicam) for osteoarthritus. I realize the need may be reduced after weight loss but age could bring it back and NSAIDS are about all there is for this.

On malabsorbtion, after looking at all the surgical schematics which distort the dimensions, I thought maybe it was only a foot bypassed. It's actually up to 5 feet which I guess could make some difference. Still, that's out of 26 feet of small intestines.

I think I'm going to stop worrying about dumping. It sounds like something that can be controlled and may happen with either surgery. GERD concerns me more. I was concerned about it because I have IBS and diarrhea with cramps has been a nemisis for a long time ?

Yep. For the record, I take Celebrex.

Hi David, my PCP is in the Franciscan network, I didn’t realize they had a WL center. I’m leaning toward the sleeve but after reading all this I’m wondering…..I will be getting the endoscopy and go from there although I don’t have any issues in that regard.

On 10/21/2022 at 9:34 PM, SpartanMaker said:

Personally, I was really worried about NSAIDS, because I have a number of physical issues that have had me on prescription NSAIDS for over 35 years now. My surgeon agreed that even with bypass, I could keep taking them as long as I continued to take a PPI to limit the risk of ulcers.

I am a little shocked to see this. I had sleeve even which I thought was less risk with NSAIDS and my doctors said I can have like ONE here and there since I am a year and a half out now as long as I take the PPI but made it sound like my only real answer for pain was narcotics. I was thinking about meeting with a pain management doctor to weigh the risk of ulcers vs addiction. I wonder why some doctors are so strict with the NSAIDs and others less so.

I had sleeve because I was worried about medication absorption. Since then I have read about tons of bypasses who are on meds, even the psyc meds I worried about and they have had zero issues. I am a year and a half out and so far no gerd issues but I have not lost all I weight and I struggle with regain. In all fairness one of my meds does clearly state is causes weight gain and with the depression I don’t exercise like I should but I still can’t help but wonder if I would be in a different boat with bypass. Don’t get me wrong I don’t regret my choice. I am glad I chose something because they are both great surgeries that will get you down to a much more healthy weight. I just can’t help but wonder what if I had chosen bypass would I be sporting my skinny jeans right now.

Edited October 31, 20223 yr by ShoppGirl

I had a higher starting weight (My highest was 382 - down to 330 by the time I saw my surgeon) … I initially wanted sleeve because of many of the reasons you stated, but was prepared for my dr to recommend bypass because of my starting weight and reflux.

After meeting with my surgeon I asked her opinion- based on my medical history and her experience of outcomes. I have IBS and for about 8 months prior to surgery was dealing with reflux. I also took a daily (2x a day) NSAID pre surgery that she advised that I stop until my post-op follow up, but that I could resume if needed after she saw me.

I was really surprised when she told me she didn’t recommend bypass for me and why. She was a surgeon who had extensive experience with all of the surgery options, so I was confident she wasn’t steering me towards what she was comfortable with routinely doing. She actually recommended sleeve (with a hernia repair) and told me if I wanted a revision later - she’d recommend going with a duodenal switch. She mentioned to me that because of the extended length of the DS surgery time, she prefers to do that surgery in two stages. I was honest and told her the second phase of that surgery scared me a little. She was very understanding about that and told me that the sleeve and bypass had very similar outcomes in the 2 yr mark, reviewed the benefits and drawbacks of each and discussed with me that she has had quite a few patients have the sleeve (at my starting weight and higher) as the 1st phase who lost enough they decided not to go on to the DS, but knew it was an option if they wanted it.

She was impressed with my weightloss up to that point and was confident with my history and medical conditions, I would be happy with the progress I would make with my surgery. I was 324 on the day of my surgery and at 10.5 weeks post op I’m down to 291. It’s definitely a slow progress, but I’ve had a few unrelated challenges in that time (being sick and dealing with issues from a car accident that occurred several years ago), but I’m headed in the right direction. At my followup she was very pleased with my progress and told me that she felt very good about the track I was on.

I’m still very early in the process, but I’m glad I asked her what she recommended and why, based on her experience and my medical history. My husband and I were both comfortable with her explanations and very confident in our decisions because I felt like we had sound information to make a decision on.

I’m hoping that I don’t decide to go in for a revision, that I can get down to a weight I’m comfortable with (I’m not sure what that number is yet, I’m hoping I know it when I feel it, lol), but if not - I know what my options are.

Right now I’m still having some issues with being able to eat enough. I’m only able to eat very small amounts at a time, but other than that everything is going well. With the weight loss I’ve had - I have been able to stop my NSAID at this point. I had also stopped my PPI meds (but recently restarted it temporarily because a sinus infection stirred things up again… hoping to stop it as soon as that clears up). My IBS is still something I’m working with but so far it has been manageable.

Best of luck in whatever you decide!

20 hours ago, MamiMB said:

Hi David, my PCP is in the Franciscan network, I didn’t realize they had a WL center. I’m leaning toward the sleeve but after reading all this I’m wondering…..I will be getting the endoscopy and go from there although I don’t have any issues in that regard.

I was actually approved for the sleeve but am switching to bypass. In my own research, and much reading of this forum, I just see too many people experiencing GERD after the sleeve. Sometimes it takes years to show up or it can happen right after surgery, but there are many, many revisions because of this. I just couldn't risk living with the kind of medication resistant GERD people describe for a couple of years then go through a revision. I see much more satisfaction from the bypass side.

I realize there are people perfectly happy with their sleeve and I hope that continues for them. This is my best decision for myself. I would just encourage you to search the sleeve forum for GERD and also stroll though the revision forum to see why they changed. The kind of GERD we are talking about makes living difficult. If not for this one issue, I would go with the sleeve, though the bypass is still considered the gold standard. Good luck with your own decision. Your surgeon can help with this.

On 10/31/2022 at 5:12 PM, David in Washington said:

I was actually approved for the sleeve but am switching to bypass. In my own research, and much reading of this forum, I just see too many people experiencing GERD after the sleeve. Sometimes it takes years to show up or it can happen right after surgery, but there are many, many revisions because of this. I just couldn't risk living with the kind of medication resistant GERD people describe for a couple of years then go through a revision. I see much more satisfaction from the bypass side.

I realize there are people perfectly happy with their sleeve and I hope that continues for them. This is my best decision for myself. I would just encourage you to search the sleeve forum for GERD and also stroll though the revision forum to see why they changed. The kind of GERD we are talking about makes living difficult. If not for this one issue, I would go with the sleeve, though the bypass is still considered the gold standard. Good luck with your own decision. Your surgeon can help with this.

I chose bypass over sleeve because of: 1. GERD. I already had it before surgery and I didn't want to take the chance of it getting worse after. 2. Dumping. I wanted the threat of dumping to help keep me in check. 3. Better resolution of my comorbidities - diabetes and high cholesterol.

On 10/23/2022 at 3:33 AM, I♡BypassedMyPhatAss♡ said:

I don't seem to dump. Although I haven't really pushed my diet much since surgery.

You're right to be concerned about GERD, wls induced GERD is awful.

I have/had? IBS-D and Bypass seems to have normalized it. My surgeon said that it would improve my symptoms. I was skeptical. But she was right it seems.

I am really glad to hear that the surgery made the IBS better. That was the one thing that I was worried about with my plans for the bypass. My dr recommended the bypass as opposed to the sleeve because of my severe GERD.