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Hope I did the right thing?



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Hi, I joined this forum last week and have found it so interesting and much more informative than what I can get anywhere else. Therefore, when I started noticing comment about acid reflux and the sleeve, I paid close attention because reflux is something I have struggled with for a long time. Mine gets so bad that it shoots into my throat and triggers something that makes it close. I can’t breathe and I struggle to get my throat to open enough for even a tiny bit of air so I don’t pass out. It is traumatic and has forced me to change things, like the way I sleep and the foods I eat, to try to make it better, which it has been. That, and the medications I take every day. That said, I can still get it and I basically freaked out the other day when there was a discussion about the difference between gastric bypass and the sleeve in regards to acid reflux. It seemed very clear that mine would probably get worse if I had the sleeve. My surgery was scheduled for Monday, but I got so concerned that I cancelled it for now. Am I right to be so concerned? Has anyone here had bad acid reflex that did not become a worse problem after the sleeve? Or got better? I am taking two months to learn more and to evaluate and will see my doctor in late January to discuss moving forward. In the meantime, I would really appreciate input from those who have some experience with this. I feel like a big baby for worrying so much about it and cancelling, especially after being so excited to do this surgery. But honestly, given a choice to struggle with weight and other issues or to live in fear of suffocating from acid reflex… I choose the former. Help!

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I assume that you've shared your reflux issues with your doctor, so what has he said about this? I've heard of some doctors who won't perform the sleeve on patients with acid reflux issues, so I'm surprised that your doctor didn't recommend bypass based on what you've described. It seems like bypass may be a better fit. If I remember correctly, bypass can actually help with reflux issues (whereas the sleeve can potentially exacerbate these issues). Whichever way you go, I don't think you're a baby for wanting to hold off and do more research :)

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I had read somewhere (not sure how accurate it was) that the bypass procedure was actually meant to treat reflux not weight loss initially. Someone please correct me if I am wrong. Other research I came across showed stats like 20-30% of sleeve patients have reflux issues post surgery. Not sure if this is long term, severe etc. verse the study I read said bypass patients only a small percent reported new or worse reflux symptoms but most reported improvement.

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My doctor actually never talked about my reflux issues. I have gastroparesis (a complication of diabetes) and sleeve is recommended to help with that. So our conversations have been about that. He did mention on my final pre-op visit that there were some possible problem outcomes of the surgery, reflux being one of them, but he never talked about my problem specifically. I’m now not even sure he knows I have it. So that is why I panicked. I need to make sure he understands how bad mine can be and see if he still recommends this surgery.

Thank you both for your input, I appreciate it so much :)

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I think you have done the right thing

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So have you thought of getting a bypass? You could discuss this option with your doctor.

I think you did the right thing.

Research and ask questions before making permanent changes to your body!

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11 hours ago, betterL8thanever said:

Hi, I joined this forum last week and have found it so interesting and much more informative than what I can get anywhere else. Therefore, when I started noticing comment about acid reflux and the sleeve, I paid close attention because reflux is something I have struggled with for a long time. Mine gets so bad that it shoots into my throat and triggers something that makes it close. I can’t breathe and I struggle to get my throat to open enough for even a tiny bit of air so I don’t pass out. It is traumatic and has forced me to change things, like the way I sleep and the foods I eat, to try to make it better, which it has been. That, and the medications I take every day. That said, I can still get it and I basically freaked out the other day when there was a discussion about the difference between gastric bypass and the sleeve in regards to acid reflux. It seemed very clear that mine would probably get worse if I had the sleeve. My surgery was scheduled for Monday, but I got so concerned that I cancelled it for now. Am I right to be so concerned? Has anyone here had bad acid reflex that did not become a worse problem after the sleeve? Or got better? I am taking two months to learn more and to evaluate and will see my doctor in late January to discuss moving forward. In the meantime, I would really appreciate input from those who have some experience with this. I feel like a big baby for worrying so much about it and cancelling, especially after being so excited to do this surgery. But honestly, given a choice to struggle with weight and other issues or to live in fear of suffocating from acid reflex… I choose the former. Help!

Sounds like you did the right thing, not sure why your surgeon didn't address this with you beforehand, but yes, if you have major GERD issues already, the sleeve will more than likely make them much worse. The reason the bypass cures GERD/Reflux issues is because of the separation of the excluded portion of the stomach being routed lower in the intestinal tract. The acids would have to travel up several feet of intestines back to your included stomach and then into your esophagus.

Never feel bad about worrying, you are worrying for a reason. Sometimes the reasons are silly, others, are justified. This is one of those justified reasons. Is the bypass not an option for you? Your last line seems to note that it's either the sleeve or nothing, curious why that is?

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I think you did the right thing. I watched my father die from esophageal cancer and it is a miserable and painful disease. Why is this relevant? Acid reflux can lead to Barrets esophagus, which can lead to cancer. Acid reflux is no joke and being concerned that the surgery could exacerbate the issue for you does not make you a baby at all.

I was pretty set on RNY before they even diagnosed me with acid reflux after my endoscopy. However, finding out the severity of my acid reflux sealed the deal for me.

I’m surprised your doctor didn’t mention any of this, as usually they discuss the possible pros and cons of each surgical option with you.

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I am also surprised that your doc didn't talk to you about reflux. I saw three surgeons before I choose which one I would use and each talked to me about my reflux. One wouldn't even do the sleeve on someone with reflux. The other two suggested that I do an endocsopy/EGD, manometry, Ph monitoring, and biopsy to see if they could suss out the causes of my reflux. Ultimately, based on those studies, they both recommended the bypass, but were comfortable doing the sleeve with a hiatal hernia repair. I'm only a month out, so it is too soon to tell the long term outcome, but my reflux is still controlled on my meds. I'm told that could change as I add more foods, so we'll see. However, I would not have done the sleeve had I not had a really good, long discussion with my doctor on the pros/cons, the data on reflux after surgery, etc. And, honestly, I can't say yet whether I made the right decision for me. Given the chance of reflux afterwards, I can't recommend what someone else should do. But I think taking a step back to think is a good thing to do. Good for you for advocating for yourself.

Maybe find another surgeon for a second opinion? Or see if you can have an appointment with your surgeon just to talk about the reflux issues?

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Thank you, thank you, thank you for these comments! You have all made me feel so much better about my decision and I appreciate that so much. To answer your question, I have only considered the sleeve because of having gastroparesis. I’ve had so many abdominal surgeries in my life that I was told to avoid any more of them...until my symptoms became so bad that I turned to the only thing that is supposed to help or cure it: the sleeve. So not sure about switching to the bypass. I need to explore further the possibilities of the sleeve. But you all have helped tremendously in giving me info to explore and question before I make this big decision. You have confirmed that this is an important topic and something my surgeon should have—most definitely—talked to me seriously about. Again, THANK YOU!

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