Hey everyone!

So I was scheduled for Gastric Bypass on 08/07/23, but after reviewing my medical history, my surgeon believes that Gastric sleeve would be a better option for me (due to Psychiatric medication I currently take and past history of addiction). I am a little worried because I heard the chances of GERD/gastritis are higher with the sleeve? I already suffer from occasional GERD and gastritis, but I agree with my doctor that the malabsorption of Gastric bypass probably isn't a good fit for me. Anyone get the sleeve and have issues with GERD/gastritis before? Did it improve or get worse? TIA ?

Following. I haven't had surgery yet so I can't say, but I am considering the sleeve in part because I take very important psych meds that I can't afford to have malabsorbed and mine don't come in a liquid formulation. I also have a history of GERD and am on a PPI already.

I talked with my psych nurse about the meds and she said the ones with the best chance of absorbing are the sleevers, she rarely has to do more than a tweak here or there. But she's had patients with bypass and DS who have had issues with passing their meds without them breaking down, so some have had to go to liquid forms which can be more challenging depending on what med you are on. I can only metabolize about 25% of psych meds so I already have a limited pool. I don't want to limit it further, it took too much effort to find a combo that works! So I'll definitely be asking the next surgeon about this...

Edited July 27, 20232 yr by ChunkCat

Yes I am completely stable now with my medications and don't want to mess with that. Will not be able to sustain my weight loss if I lose my mind lol. I'm on an anti depressant, benzo and mood stabilizer. My psychiatrist said we may have to up my dose after gastric bypass. I really don't want to do that I'm on low to medium dose right now and want to keep it that way. My benzo could be liquid form but the rest can't. My surgeons office made it seem like since my gastritis and Gerd isn't bad enough to be on medicine (I just take Alka seltzer or Picot when it acts up) I should be fine. Sucks that my choices are basically being morbidly obese, worsening gastritis and Gerd or not getting my psych meds. Not getting my meds would be most disastrous and being obese with all my other health problems would be as well so I'm going to follow my Dr suggestion and do the sleeve and hope for the best I guess. When is your surgery date?

That happened to me. I had the option for either surgery, so I chose the sleeve because I have MS and take several meds that can't be crushes, broken, and don't come in alternate forms. For the first 8 months, things were great. Then the GERD hit, which became gastritis and esophagitis, which was so bad it caused me to need 80mg daily of Nexium (and still had gerd break through), which caused polyps to develop throughout my stomach. 4 endoscopies later, I had no choice but to get the revision to bypass. Never been better. The PPI is down to 40mg per day and at 6 weeks post op we'll go down to 20mg daily and at 10 weeks we'll see how I do without any at all. The pain from the bypass was SO much less than the sleeve, the ability to get in my pills and fluids are SO SO much better. I wish I had just done it first. As for my MS meds, I am still on them, but since we know it's basically like taking 1/2 doses (that's the way it is for extended release, but not so much full release that requires the med to be taken more than once per day) I am having a MRI at 3 months post op (unless I have break through symptoms start before that) and if that's the case, I'll go on a different med (likely an IV infusion med that I would have to do 1x per week). There's ways around things with the bypass. Talk to your psych dr and see what can be done about your meds before completely writing off the bypass. I wish I had just skipped the sleeve, to be honest.

I don't have issues with my GERD any longer since getting the sleeve. Understand this is my experience and everyone's is different. Your surgeon is experienced in this surgery, has seen other patients similar to you and your medical history and what works best over all. If you follow your meal plan and your dietician's meal plan your GERD should be fine. I can't stress enough keeping in contact with your physician's office after your surgery and reporting anything that is concerning to you. You and your doctor should have a plan for your meds immediately after surgery. Write down your questions and talk to you surgeon or his nurse about your specific needs.

I never had GERD before surgery but have it now and its a pain. If I eat too late then I suffer all night. It keeps me honest.

Fat without GERD made me miserable, Thinner with GERD, very happy

15 hours ago, MasonMoonGirl said:

Sucks that my choices are basically being morbidly obese, worsening gastritis and Gerd or not getting my psych meds. Not getting my meds would be most disastrous and being obese with all my other health problems would be as well so I'm going to follow my Dr suggestion and do the sleeve and hope for the best I guess. When is your surgery date?

I feel you! Being in this situation is no fun. I don't have a surgery date yet, I didn't like the first surgeon I saw so I go see a new one on August 3rd. Hopefully one that will answer my questions and think a little outside the box.

I'd talk it out with the surgeon (or his nurse/PA) a little more to understand his thought process. He sees more patients than you or I do, he should know what the risk of GERD is vs the risk of not absorbing your meds. I think I read about 30% of sleeve patients get new or worsened GERD/gastritis from the surgery?? That means there is a 70% chance you won't have that issue. For those that have it, it seems very frustrating, but I haven't seen any data on how many sleeve revisions are from GERD.

I wish my meds (and autoimmune disease) were flexible enough to give me 3-6 months to figure out new dosing strategies, but they aren't. If I go into a med induced depression flare I will lose the benefit of the surgery because I won't be able to function well enough to make good food and get exercise. Not everyone has depression that severe though. I think a lot of patients have some flexibility there and can afford to play around with their meds to find a new combo. I will be fine with handling some tweaking to the dose, but I don't have the option of another med combo. Everyone is different though and it is worth talking it out with the doctor until you feel sure about your choice!

As part of the workup for my gasrric sleeve procedure, I had to have an endoscopy, in order to determine if I had GERD & how bad it was. Well, it turned out that mine was BAD, so 6 mos. before I had my gastric sleeve, my doctor told me that I would need a procedure called a fundoplication, which relieves the GERD, since GERD only gets worse after the sleeve procedure. In fact, he wouldn't do the sleeve unless I had the fundoplication surgery. So I had it & in July 2021 I had the sleeve. I can count on one hand the number of times I have experienced GERD since having the fundoplication. And it was good preparation for the sleeve, since the dietary restrictions for the first 6 weeks were very similar.

Thank you for this post! I decided to make an appointment with my gastroenterologist before moving forward. It sucks because it Is delaying my surgery. But I want to make the best decision and it needs to be addressed.

I had the sleeve in 2016 and never had Gerd until the surgery. Got bypass in September of 2022, and it feels so good not to have Gerd and take nothing, and I have reached my goal weight....Go for the bypass..

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