Endoscopy and Sleeve?

[lunadreams 22]

I have to go for an endoscopy before surgery, and have my first visit with the GI doc on Monday.. When I was talking with my surgeon today and expressing concern about nausea on the liquid diet, and I shared with her that I tend to get really nauseated in the morning before I eat and at night if I don't have a little something before I lie down, she said it sounded like "classic gastritis" (as well as some GERD).

I wish I'd asked her...does having gastritis and/or GERD rule you out for sleeve, or can it be treated/managed? I really don't want the lap-band, which is the other surgery she suggested for me, and I was hoping to avoid the bypass, as well, because of malabsorption issues.

Edited March 20, 2021 by lunadreams

[Creekimp13 5,840]

I had to go in for an endoscopy before my surgery. I had acid reflux from my very large hiatal hernia. There was a little concern about an ulcer, so we tested for ulcer bacteria. This is something you really want to resolve BEFORE the surgery, so if there is any concern, an endoscopy is a good idea.

Gastritis should not rule out sleeve for you. But given your symptoms, taking a look around physically with an endoscope is a smart thing to do for your safety.

[catwoman7 11,161]

I wouldn't do the lapband at all, and I'm surprised your surgeon still does them. Few surgeons do those anymore and lots of people have had theirs removed because of complications.

if you have GERD, just know that it gets worse for about 30% of sleeve patients. You may be OK with that amount of risk - I was not, so I went with bypass. Bypass usually (but not always) improves if not outright cures GERD. Having GERD won't prohibit you from getting the sleeve, though - but just know your risk if you do have it and you decide to proceed with the sleeve. Sometimes it can be medically managed, but we do see a fair amount of revisions to bypass on here if the GERD gets really severe (and again, that doesn't happen to most people - but it does happen to some..)

P.S. Malabsorption issues aren't common with bypass AS LONG AS people are consistent about taking their Vitamins. There are some people who can't absorb Iron very well from oral supplements, so they need to go in for occasional infusions, but most of us absorb iron from pills just fine. As far as other nutrients, again, as long as you keep on top of your Vitamin regimen, problems are rare.

Edited March 20, 2021 by catwoman7

[Creekimp13 5,840]

Catwoman is dead right about the risk of GERD with sleeve. That said...if your GERD is being caused by a hiatal hernia and you have it repaired with your sleeve surgery...it can result in resolving the GERD. This was the case for me...I had awful acid reflux, but since surgery have not had any. So...it's individual.

I avoided Gastric Bypass because people in my family are prone to Iron deficiency, and taking heavy iron supplements makes me super nauseated. I have a relative who had gastic bypass who continues to significantly struggle with iron and a few other trace nutrients. It's a catch 22. Weigh the risks and benefits specific to your situation. Getting the endoscopy will give you more information to work with.

In the end, you try to get the best information you can....line up the best doctor you can (can't hurt to get a couple of opinions)...and take your chances. No guarantees.

Best wishes.

[lizonaplane 1,612]

I never knew that being nauseous in the morning before eating was due to gastritis! That's always been the case for me. I wanted gastric bypass but because I have bipolar disorder, the surgeon and my psychopharmacologist both strongly suggested the sleeve instead, because of not being able to manage the bipolar meds as easily with the bypass. The surgeon knows I have gastritis/GERD but he still feels that way. They don't do band at this location and I wouldn't consider it anyway. I'm already on omeprazole. I guess we'll see what happens...

[SunnyinSC 137]

I had an endoscopy yesterday as part of the pre-surgery process for me. I've had GERD issues for a while, and my nurse wanted to make sure there wasn't something more there going on before getting a sleeve (which was the surgeon's recommendation based on my weight). Turns out I have a medium-sized hiatal hernia of the paraoesophageal type. Based on this we're actually going to go with bypass.

According to the nurse, while it's possible the GERD would go away with the sleeve if the hernia was fixed, it's also not entirely uncommon for sleeve users to get another hernia later on due to the reduced size of the stomach, and then we'd be back to square 1 with the GERD issues (with them possibly being worse due to the new stomach). Where I am self-pay and a revision would not be covered by insurance, we have decided to go with bypass instead as I essentially have one chance to get this right. That is just for me though, and everyone is so different with multiple other factors at play that it may not be the right choice for others.

Either way, I'd say an endoscopy will likely be beneficial. Doesn't hurt to have more information going into such a big decision, and the results may help you decide what type of surgery would work best for you.

Edited March 26, 2021 by SunnyinSC