rny Help! Increased heartburn AFTER my RNY - 4 wks post op

[Miserable 27]

One of the top three reasons I chose to have the RNY gastric bypass is to get relief from the horrible heartburn that I experienced from GERD and to hopefully (ultimately) get regression from Barrett's Esophagus.

Not daily, but once or twice a week since surgery, I have had worse heartburn then I ever experienced prior to surgery. I am taking the same medicine (40mg Prilosec and my surgeon told me to add 300mg of Zantac after the first week) and my diet is the blandest it has ever been. I literally only eat vanilla OIKOS Zero yogurt, bananas, almond milk, Premier Protein, no sugar added applesauce, plain rolled oats and chicken broth.

I am scared. Could this be an ulcer? A leak? Or is this just a normal part of healing that I will only experience in the beginning and will then live a more comfortable life? I had read so many wonderful storied about how people never experienced GERD again after RNY....many had RNY just to get relief from GERD.

Anyone else out there having issues with heartburn like me?

[James Marusek 5,244]

Your diet look pretty bland as you said. You are taking Prilosec, which is a proton-pump inhibitor, so that is good. Could be an ulcer. According to the internet:

Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.

So the other two things they recommend is (1) stay off any NSAIDs, such as aspirin and Excedrin (which contains aspirin) and a host of many other NSAIDs and (2) make sure you were tested for Helicobacter pylori infection. This is a common infection that is hidden, so you may be a carrier and not know it. It can also be a hard bug to kill.

I would make your surgeon aware of the difficulties you are experiencing.

[Miserable 27]

Thanks, James!

That was very informative. Gratefully, I am a very compliant patient...out of sheer fear of something going wrong. So I stopped all aspirin and NSAID products two months prior to surgery and plan to never use them again. I was tested for H-pylori every year for endoscopy for the past 8 years, so I don't have that.

I did contact the surgeon, so I'm being carefully watched. They are now rare instances. He prescribed prescription Zantac 300mg to take late in the day in addition to the PPI that I am to continue with. So far, good relief.

But I'm watching out for that ulcer...that is exactly what I was worried about.

Thanks for taking the time to respond to me with a really well thought out response.

[James Marusek 5,244]

I hope all works out for you and that your problems are minimized.

[Miserable 27]

All symptoms disappeared and I'm doing really great now!

Time heals all

[kakatlady612 1,053]

Overjoyed to hear your Good news. I'm pre surg with similar things going in, now you've inspired me, already knew it's the correct decision for me. Send good thoughts my way in March, okay?

Sent from my VS880PP using BariatricPal mobile app

[Native Girl 13]

One of the top three reasons I chose to have the RNY gastric bypass is to get relief from the horrible heartburn that I experienced from GERD and to hopefully (ultimately) get regression from Barrett's Esophagus.
Not daily, but once or twice a week since surgery, I have had worse heartburn then I ever experienced prior to surgery. I am taking the same medicine (40mg Prilosec and my surgeon told me to add 300mg of Zantac after the first week) and my diet is the blandest it has ever been. I literally only eat vanilla OIKOS Zero yogurt, bananas, almond milk, Premier Protein, no sugar added applesauce, plain rolled oats and chicken broth.
I am scared. Could this be an ulcer? A leak? Or is this just a normal part of healing that I will only experience in the beginning and will then live a more comfortable life? I had read so many wonderful storied about how people never experienced GERD again after RNY....many had RNY just to get relief from GERD.
Anyone else out there having issues with heartburn like me?

I heard that creamy dairy.products after the Ry could cause you to get very sick. I.was at a.support group and it.was mention that a few.got really sick and.that OIKa yogurt is thick like cream.

[Miserable 27]

It is dairy. It was on my surgeon's list to start eating when I came home from the hospital - only one teaspoon at a time. Worked great for me and was very soothing. I still eat it every day for Breakfast, but now it the whole 3.5 oz and add a handful of fresh blueberries