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GERD---Gastric Bypass vs Sleeve



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i have been researching this issue (if you should have bypass or sleeve if you have GERD/heartburn) and have found contradictions on the information. There's been people on Bariatric Pal who could not get sleeved because of GERD. However,I personally know several people who had GERD and still were sleeved. One was on GERD medication before surgery and no longer need to take it and the other two had GERD before surgery and now they don't have it at all and they are on no medication. I am really confused about this. My consultation is very soon and would like to know any information so it will help me to know what questions to ask.

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One major factor is what is causing your GERD. Many obese people have hiatal hernias, which cause GERD. If that is the case, the hernia is typically repaired at the same time as the sleeve surgery and that can cause your GERD to resolve or improve. But if it is not caused by a hernia, some surgeons will refuse to perform a sleeve, or strongly recommend bypass, because bypass is typically much better for GERD. A lot of it depends on how bad your GERD is, as well.

You will typically have an upper GI series or endoscopy prior to surgery, and that can help figure out what is causing your GERD, i.e., do you have a hiatal hernia.

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I agree with the hernia theory... They just diagnosed my hernia and told me it would be fixed when I'm sleeved and will likely stop my reflux. I take meds for GERD daily. There is something to be said for those that have a combination of medical issues and the amount of weight they have to lose factoring into the doctors recommended treatment... Possibly GERD may be a lesser evil in considering other things the patient has to overcome?

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I think it depends on the patient and the surgeon. I was sleeved with GERD, but it had only been correctly diagnosed at my pre-op EGD. I'd been treated for asthma for YEARS as mine produced chronic coughing rather than heartburn. They found a hernia in that EGD and the doc was pretty confident that with the hernia repair, weight loss and medication, I'd be fine, but did warn me if I still suffered, the only "fix" was revision to bypass. It got worse for about a month, (uncontrollable coughing right after stomach surgery is NOT a good time), but then GREATLY improved as I healed and lost weight. I have been fine taking 40mg of Omeprazole 2x day and probably will for life. A small price to pay to regain my health!

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I've also heard from many sleeve patients that GERD actually becane a problem for them several years down the road after surgery.

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