GERD before surgery advice

[AchieveGoals 46]

Hey guys, so I don't have my surgery yet, I'm still in the 6 month visit phase. Currently, I suffer from a bit of heartburn now and then. I would say once a week maximum, and usually gets relief if I take 1 tablet of Tums. Do you think this is a sign that I should NOT go for sleeve and choose RNY instead? What is your input? I ask because I want to hear actual patient input on their experience with GERD and the VSG.

Thank You!

[NovaLuna 710]

My surgery has a sleeved stomach and while I don't have GERD I have EOS (a.k.a EOE: Eosinophilic Esophagitus) which causes acid issue at night. I used to have to take two acid reducers at night, but after my surgery I only need to take 1. I was surprised by that as I actually thought it'd get worse... So while acid issues do tend to get worse for most people who have VSG (or DS or Loop DS), I think there are also a rare few who it improves upon. At least that's what I've taken from my own experience.

In the end it comes down to whether you're willing to take the risk that you may have to end up having to have a revision because it makes your GERD worse.

[New&Improved 1,780]

4 hours ago, AchieveGoals said:

Hey guys, so I don't have my surgery yet, I'm still in the 6 month visit phase. Currently, I suffer from a bit of heartburn now and then. I would say once a week maximum, and usually gets relief if I take 1 tablet of Tums. Do you think this is a sign that I should NOT go for sleeve and choose RNY instead? What is your input? I ask because I want to hear actual patient input on their experience with GERD and the VSG.

Thank You!

Most cases sleeve stomach will make it worse unfortunately.... There's 1000s of posts about it....

[S@ssen@ch 745]

In my experience, worsening GERD with VSG is a bit of a hit or miss.

A friend of mine who encouraged me to have the sleeve had silent reflux with the lap band that turned into early-stage Barrett's esophagus. Her surgeon actually recommended the sleeve for her and she hasn't had issues since. Her Barrett's resolved and she's very happy.

I also had reflux with the lap band. Not so bad as to develop Barrett's, but annoying just the same. My lap band surgeon recommended conversion to the sleeve. I didn't do it when I had my lap band out, mostly because I was afraid. Fast forward about 6 years and I had gained most of my lap band weight. I suffered from occasional nighttime indigestion, but otherwise had little signs of reflux. My doctor and I decided that the sleeve was the best option for me. About a month after the sleeve I started getting heartburn. This was easily remedied with a PPI (Nexium). It was pretty bad in the 1st year and I had some issues with esophagitis. So, I saw a GI doc. Today I will still have occasional nighttime reflux, but I practice a lot of habits to reduce my risk of nighttime reflux. For the most part, my reflux is well-controlled. I have it, but it's not unmanageable. My GI doc and I are considering stretta in the future, but it's been pushed asked until the COVID-19 risk is gone because it's not urgent or anything.

[catwoman7 11,221]

it's a real crap shoot. It gets worse for some, but not for others. I wasn't willing to take the risk, but some people are. SOOO....it's hard to say..

[Lanie992 168]

My GERD got better with the sleeve, but I had a hiatal hernia repair ---which I think was the cause of my pre-surgery GERD. But just from reading here - seems like a lot of sleevers do develop GERD after surgery and some subsequently get bypass to help relieve it.

[mcfluffington 179]

I heard that a lot of people get the bypass to help with GERD.

When I had the bypass I had no trouble with GERD.

Now that I have gastric sleeve I have a problem with it. though it is mostly taken care of with Nexium or Prilosec.

[STLoser 1,099]

I really struggled with what surgery to get, because I have pretty severe NEED, although it's controlled with Nexium.
I was self pay, so I knew there is no chance for me to get a revision. My starting BMI was 69 and my surgeon recommended Loop DS to me. He never seemed too concerned about the GERD. I didn't want to spend so much money and not be able to keep the weight off, and since he said Loop DS has less chance of weight regain, I chose it. I was willing to take the risk of my GERD worsening.
I'm a little over 3 weeks post op and I haven't had any issues with GERD so far. I hope I don't have any!

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[STLoser 1,099]

I really struggled with what surgery to get, because I have pretty severe NEED, although it's controlled with Nexium.
I was self pay, so I knew there is no chance for me to get a revision. My starting BMI was 69 and my surgeon recommended Loop DS to me. He never seemed too concerned about the GERD. I didn't want to spend so much money and not be able to keep the weight off, and since he said Loop DS has less chance of weight regain, I chose it. I was willing to take the risk of my GERD worsening.
I'm a little over 3 weeks post op and I haven't had any issues with GERD so far. I hope I don't have any!

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Not NEED, GERD. Stupid autocorrect!

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[Bastian 458]

I heard that a lot of people get the bypass to help with GERD.
When I had the bypass I had no trouble with GERD.
Now that I have gastric sleeve I have a problem with it. though it is mostly taken care of with Nexium or Prilosec.

I'm confused how did you have a bypass then a sleeve?

[SeattleLady 277]

Hey guys, so I don't have my surgery yet, I'm still in the 6 month visit phase. Currently, I suffer from a bit of heartburn now and then. I would say once a week maximum, and usually gets relief if I take 1 tablet of Tums. Do you think this is a sign that I should NOT go for sleeve and choose RNY instead? What is your input? I ask because I want to hear actual patient input on their experience with GERD and the VSG.

Thank You!

I occasionally got heartburn before my sleeve. At year 3 my GERD became horrible.

I had a herna repair in December. The GERD is better. I am still happy that I picked the sleeve due to having low Iron and other absorption issues. Bypass would have killed me. I am now in year 6. Not sure what to due next about GERD. However, I'm not given up.


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[AlwaysCruising 100]

On 8/12/2020 at 9:18 AM, S@ssen@ch said:

In my experience, worsening GERD with VSG is a bit of a hit or miss.

A friend of mine who encouraged me to have the sleeve had silent reflux with the lap band that turned into early-stage Barrett's esophagus. Her surgeon actually recommended the sleeve for her and she hasn't had issues since. Her Barrett's resolved and she's very happy.

I also had reflux with the lap band. Not so bad as to develop Barrett's, but annoying just the same. My lap band surgeon recommended conversion to the sleeve. I didn't do it when I had my lap band out, mostly because I was afraid. Fast forward about 6 years and I had gained most of my lap band weight. I suffered from occasional nighttime indigestion, but otherwise had little signs of reflux. My doctor and I decided that the sleeve was the best option for me. About a month after the sleeve I started getting heartburn. This was easily remedied with a PPI (Nexium). It was pretty bad in the 1st year and I had some issues with esophagitis. So, I saw a GI doc. Today I will still have occasional nighttime reflux, but I practice a lot of habits to reduce my risk of nighttime reflux. For the most part, my reflux is well-controlled. I have it, but it's not unmanageable. My GI doc and I are considering stretta in the future, but it's been pushed asked until the COVID-19 risk is gone because it's not urgent or anything.

I am in a similar position, but earlier in my journey. I had Gerd before surgery but it’s been much worse after. I was slaved on 6/18/ 2020. They did an upper G.I. last Friday and I will reflect three times within like a minute of her watching. I didn’t realize it was that often, although I have realize there was more acid in my stomach that there needed to be because it creates a sensation of been hungry for me.

The nurse practitioner for the surgeon called me and she said (a) it could get better as I today am just 8 weeks out and not fully healed (per her) and (b) a future fundoplication type procedure might be needed (he does some beaded ring version). I asked about the option of switch to a Bypass instead and she said she would talk to the surgeon about which of those 2 would be the best future option. Notably he does a lot of the fundoplication so maybe will lean that way? She also suggested that they do another scope but with two special procedures with it. OY.

Please keep me updated on your progress, I wish you luck!

Edited August 18, 2020 by AlwaysCruising

[S@ssen@ch 745]

@AlwaysCruising You might want to give it some time. My GERD got much better after a year. I still get a "flare-up" once in a while, but honestly, the only reason I went to a GI doctor was because I wanted to discuss long term options. I was feeling good but was concerned about long-term PPIs and I was not interested in revision. #1-I didn't feel my condition was severe enough to consider that. #2-If I wanted the bypass, I would have gone for it the 1st time around.

My GI doctor offered me the LINX procedure or the stretta procedure. The LINX is a ring of metal/magnetic beads that they install at the place where your stomach and esophagus meet. The magnets keep it closed so that the acid doesn't keep going up into your esophagus. The STRETTA procedure thickens the lower esophageal sphincter with radiofrequency waves. Same principle as the LINX, it helps close off the sphincter so acid doesn't wash into the esophagus. I was NOT interested in having more hardware installed in my body and I have seen the good things that radiofrequency can do for other conditions, so I chose STRETTA. Unfortunately, my insurance plan doesn't agree and I'm facing paying for it out of pocket. That's what we had planned before COVID hit. I'm not having any problems that would warrant anything urgent, so I wait.

Advice for you or anyone with GERD: do your research. There are a lot of lifestyle changes you can make and supplements you can take to help them. God knows I've tried most of them and spent lots of $$ on so-called GERD cures/treatments. So far, what works best for me is sleeping on a wedge and NEVER eating within 3 hours of bedtime. I actually have 2 wedges and if I feel that it's bad, I will sleep on 2 of them (not fun, but it helps) to reach about a 45° angle. I make sure I get plenty of fluids. AND, for the game-changer: DIGESTIVE ENZYMES. I started taking digestive enzymes with my dinner and my reflux got lots better. I read an article that theorizes that a lot of GERD is caused by undigested food in the stomach when you go to bed (hence, no eating within 3 hours of bedtime). I must have slow digestion or something because as soon as I started taking the digestive enzymes, I noticed a big difference. No bloating. No rock-gut. Significantly reduced reflux.

[AlwaysCruising 100]

@S@ssen@ch hi - I didn’t say this because it didn’t seem pertinent at the time, but I’m a health care provider and fairly aware of the options overall. I wasn’t specific, but of course the LINX procedure is the one my surgeon now does. It is too soon for the second scope in my view, and normally would not have posted about it at all, but the topic was already started 🙂 I so hope some of this remits sooner and not later.

I appreciate your effort at helping.

Edited August 18, 2020 by AlwaysCruising

[ladyJ2198 10]

I have Gerd I take 40mg of Prilosec a day before surgery 7/14 I had the sleeve. I was warned it could get much worse but it actually got better. I haven’t had heartburn once and I barely take my medicine anymore lol