Acid Reflux -- How Much is Too Much for VSG?

[Kris 78]

Hi all,

This is my first post after having lurked here for while. After a lot of research, attending a WLS seminar, and doing some serious soul-searching I have applied to have VSG with Dr. Aceves in January. Yay for me -- I'm so excited! But I do have a question about something that is bothering me.

I have regular problems with acid reflux, meaning I take an over the counter Pepcid AC pill about 5 nights a week (anytime I've eaten or drunk something at dinner that might be a problem later, like diet coke with lemon, or Tomato based sauces, or fried food -- unfortunately most of my favorite foods and beverages are problem foods for me!). The acid reflux is easily managed with a daily pill and if I don't eat any problem foods I usually don't need a pill (however, if I eat a problem food and skip the pill, most likely I will wake in the night with that horrible acid shooting up my esophagus). I haven't asked my primary care physician for any prescription strength acid reducing meds because the over the counter meds work just fine for me, but as a result of not talking to my PCP I haven't had an official diagnosis of GERD or acid reflux disease.

I know that VSG can actually make acid reflux worse and maybe Dr. Aceves will not recommend this surgery for me.

I also understand that a lot of people who need/get VSG surgery also get a hiatal hernia repair while the dr. is doing the surgery (and I expect if I am cleared for surgery Dr. Aceves will likely find I have a hiatal hernia).

I guess I am just looking for some reassurance on this point and benefit from fellow VSGer experience. I will definitely be cutting back on the problem foods now that I have applied for surgery, and hopefully that will significantly reduce my problem. I have not really tried to do much about it since I feel that I control it pretty well with the Pepcid AC, but now that I have applied for surgery I'm having worries that the VSG could turn a currently manageable issue into an unmanageable one.

I definitely do not want any other type of WLS -- especially not gastric bypass, which in my understanding is the recommended WLS for people with acid reflux (however, I don't want the side effects of gastric bypass). I've read/seen that lap band can exacerbate acid reflux too, so that is not really an option especially due to so many problems that can occur with lap band.

Any insight you can share is wonderful, thank you!

[Tiffykins 673]

Some people's reflux resolve with the sleeve others have more acid issues. I know Dr. Aceves prescribes Nexium for his patients for at least 3-6 months post-sleeve and you can buy it super cheap in Mexicali. The Nexium and other PPIs (Prilosec Protonix and Prevacid) work differently than Pepcid AC(h2 blocker and Zantac). The Nexium will actually stop the acid from overproducing while the Pepcid just treats the symptoms. I'm on Prilosec once daily and haven't had any issues with acid reflux. I could wean off of it, but I really like not being hungry, and don't want to deal with reflux at all. For me, I'd rather take my Prilosec, and go about my day without having to avoid certain foods and no worries of reflux.

The sleeve can sometimes worsen reflux and you might have to take a PPI long term. Some surgeon prescribe a h2 blocker instead of a PPI, but most often those patients end up switching over to a true PPI to get resolution of their reflux. Plus, acid can cause false hunger, and the PPI takes care of that issue. I didn't have reflux pre-sleeve, even with my band, I didn't have issues. But, close to 6 weeks out, I was getting this funky, twinge, gnawing in my stomach after I'd eat with the sleeve. After talking to several sleeve veterans, they said it could be false hunger from acid, went to my surgeon, got on Prilosec and never had any other issues.

[Kris 78]

Some people's reflux resolve with the sleeve others have more acid issues. I know Dr. Aceves prescribes Nexium for his patients for at least 3-6 months post-sleeve and you can buy it super cheap in Mexicali. The Nexium and other PPIs (Prilosec Protonix and Prevacid) work differently than Pepcid AC(h2 blocker and Zantac). The Nexium will actually stop the acid from overproducing while the Pepcid just treats the symptoms. I'm on Prilosec once daily and haven't had any issues with acid reflux. I could wean off of it, but I really like not being hungry, and don't want to deal with reflux at all. For me, I'd rather take my Prilosec, and go about my day without having to avoid certain foods and no worries of reflux.

The sleeve can sometimes worsen reflux and you might have to take a PPI long term. Some surgeon prescribe a h2 blocker instead of a PPI, but most often those patients end up switching over to a true PPI to get resolution of their reflux. Plus, acid can cause false hunger, and the PPI takes care of that issue. I didn't have reflux pre-sleeve, even with my band, I didn't have issues. But, close to 6 weeks out, I was getting this funky, twinge, gnawing in my stomach after I'd eat with the sleeve. After talking to several sleeve veterans, they said it could be false hunger from acid, went to my surgeon, got on Prilosec and never had any other issues.

Tiffykins, thanks so much for that very thorough response! I will check to see if I should switch over to a PPI prior to the surgery to minimize any problems during and post-surgery. I already have a couple of packets of Prilosec so could switch over tomorrow if needed. Thanks again!

[Tiffykins 673]

Tiffykins, thanks so much for that very thorough response! I will check to see if I should switch over to a PPI prior to the surgery to minimize any problems during and post-surgery. I already have a couple of packets of Prilosec so could switch over tomorrow if needed. Thanks again!

You betcha ! ! ! Even though the OTC version of Prilosec doesn't indicate to take it on an empty stomach, my RX version advises to take 1 hour before eating anything. I forgot to fill my RX one time for a week, and I didn't take the OTC version on an empty stomach, and I had some mild reflux twice that week. It wasn't anything horrible, but I would take it on an empty stomach. Nexium is labeled to take on an empty stomach and wait 30 minutes before eating.

[Stacy160 201]

You sound EXACTLY like me before surgery -- I could have written that post. I did have a hiatal hernia that was found (didn't know about it beforehand) and fixed during surgery and I have not had ANY heartburn or reflux at ALL since then.... it's been such a huge relief!!

[Secret Surgery 34 4]

I like stacy160 had a hiatal hernia found during surgery. I am just over a week out and have had zero heartburn. I use to take extra strength zantac up to 5-7 times a week. Depending on how bad I eat/drink. Good luck to you.

[klus263 9]

I would have on occasion acid reflux but did not take any medications. I was sleeved on Dec 1st and they found a hiatal hernia which they repaired. While in the hospital they gave me iv prescription to reduce acid and when I was discharged, a rx for liquid nexium. I have not had a single issue with any reflux since surgery. Good Luck.