Sleeve to Bypass for Reflux

[hayyouljkb 4]

Hi. I'm having a Sleeve to Bypass revision on 01/16/23 due to severe reflux. I was wondering if anyone has had this revision surgery and if they have noticed a difference? Good? Bad? How was the recovery time for the Bypass vs the Sleeve. I'm just frustrated that I have to start all over again. Thank you.

[Tomo 1,191]

I had it done about a year and a half ago (for gerd). All good, nothing negative to report, much easier recovery, much easier everything actually.

[hayyouljkb 4]

Oh thank you! That is so encouraging.

[GreenTealael 25,335]

I had it done 3+ yrs ago and no more GERD. Recovery was also easier since I knew what to expect.

[lucielu 21]

I had my revision 11/30. Zero reflux since. Recovery was a little bumpy and tough with nausea and pain but nothing major so y happy for that. I was going to take 2 weeks off and extended it to 3. So happy so far

[hayyouljkb 4]

Thank you so much for the feedback it is so helpful!

[mocha2871@yahoo.com 10]

I had the surgery 2 yrs ago. I have not had any issues. I do experience dumping after this surgery but that's my fault.

Sent from my SM-G781U using BariatricPal mobile app

[Smallbites2015 21]

Hi everyone glad to have found you. Happy New Year. I am six month out from sleeve to bypass for severe GERD. I am still learning what this little tummy likes. Unfortunately dumping is frequent and nausea when too much carbs/sugar. My biggest frustration now is not having a trigger of when I am full until it’s too late and then I’m miserable. I just don’t feel the restriction immediately like I did with my sleeve, it’s more of a delayed reaction so I am having to pay more attention. I can say I have lost the 20 pounds I put on so that is a plus. Still have high blood pressure and had to change my meds around since no more long acting meds allowed but my cholesterol is normal for the first time in 7 years! And yes GERD is gone. I feel a little heat with spicy food but it quickly goes away. A plus to this surgery is I can eat salad again!

Edited January 4, 2023 by Smallbites2015

[CeciliaInPNW 7]

I had revision to bypass on 12/13/22 due to GERD/acid reflux that also caused some regain. Recovery for me was a lot worse than sleeve, but thankfully that sounds uncommon so please do not get nervous reading my story; I only tell it to share my experience.

I was scheduled for outpatient surgery, but had to be admitted for one night to the hospital due to not coming out of the anesthesia quickly, an abnormal EKG post-surgery and low blood pressure issues. I spent about 8 hours in post-op recovery and was finally admitted when I didn't improve. I suspect the difference in recovery had to do with the first surgery being done at my doctor's clinic, while the bypass was performed at a hospital (insurance requirement) so same doctor, different surgical team/anesthesiologist. I was given something pre-anesthesia which the nurse told me can make coming out of anesthesia more difficult. I requested that they not give it to me, but I was asleep before the mask went on my nose, so I suspect I was given it even though the nurse told the anesthesiologist I didn't want it. I was also given fentanyl in post-op, which I would not have approved had I been awake enough to object to it. I guess it is common in emergency rooms, but I was not happy to hear them saying they were administering it to me while I was mostly asleep. I also got a corneal abrasion during surgery, which caused intense pain and watering in my left eye in post-op. They gave me drops for it and it calmed it down. Other than these issues, my post-op stay at the hospital was great - I had an amazing team of nurses that seemed like they were dedicated only to my care.

Comparing to my sleeve post-op, for that surgery I was released same day just hours after surgery and aside from being sleepy for a day or two, I had no post-op issues except for Constipation, which I have not had with bypass.

I had a JP drain for 1 week post-surgery. I continued to have low BP for a few weeks post-surgery and very little energy. I didn't eat much for the first 2 weeks (I completely overbought on the liquids and puree foods). I was able to get my Water in no problem. I wasn't able to stomach the Protein Shakes until week 3, they just gave me nausea. At about the 3-week mark I suddenly recovered one day from both the low BP and low energy, and now I am feeling amazing. Aside from a little heart burn a few days out of surgery I have not had any GERD/acid reflux, thank god!

So far with bypass I have not regained my hunger pangs yet (yay! hope that lasts a while) and am down 20 lbs, compared to having lost 18 lbs my first month post-sleeve. I'm very happy I had the revision surgery at this point. Try to not feel frustrated, my doc told me many people need a revision, especially with GERD. I didn't realize just how much it affected my sleep, eating, daily life until it went away. Such a relief to have it gone!

I wish you the best of luck in your surgery!

[hayyouljkb 4]

11 hours ago, LynnfromPNW said:

I had revision to bypass on 12/13/22 due to GERD/acid reflux that also caused some regain. Recovery for me was a lot worse than sleeve, but thankfully that sounds uncommon so please do not get nervous reading my story; I only tell it to share my experience.

I was scheduled for outpatient surgery, but had to be admitted for one night to the hospital due to not coming out of the anesthesia quickly, an abnormal EKG post-surgery and low blood pressure issues. I spent about 8 hours in post-op recovery and was finally admitted when I didn't improve. I suspect the difference in recovery had to do with the first surgery being done at my doctor's clinic, while the bypass was performed at a hospital (insurance requirement) so same doctor, different surgical team/anesthesiologist. I was given something pre-anesthesia which the nurse told me can make coming out of anesthesia more difficult. I requested that they not give it to me, but I was asleep before the mask went on my nose, so I suspect I was given it even though the nurse told the anesthesiologist I didn't want it. I was also given fentanyl in post-op, which I would not have approved had I been awake enough to object to it. I guess it is common in emergency rooms, but I was not happy to hear them saying they were administering it to me while I was mostly asleep. I also got a corneal abrasion during surgery, which caused intense pain and watering in my left eye in post-op. They gave me drops for it and it calmed it down. Other than these issues, my post-op stay at the hospital was great - I had an amazing team of nurses that seemed like they were dedicated only to my care.

Comparing to my sleeve post-op, for that surgery I was released same day just hours after surgery and aside from being sleepy for a day or two, I had no post-op issues except for constipation, which I have not had with bypass.

I had a JP drain for 1 week post-surgery. I continued to have low BP for a few weeks post-surgery and very little energy. I didn't eat much for the first 2 weeks (I completely overbought on the liquids and puree foods). I was able to get my Water in no problem. I wasn't able to stomach the Protein Shakes until week 3, they just gave me nausea. At about the 3-week mark I suddenly recovered one day from both the low BP and low energy, and now I am feeling amazing. Aside from a little heart burn a few days out of surgery I have not had any GERD/acid reflux, thank god!

So far with bypass I have not regained my hunger pangs yet (yay! hope that lasts a while) and am down 20 lbs, compared to having lost 18 lbs my first month post-sleeve. I'm very happy I had the revision surgery at this point. Try to not feel frustrated, my doc told me many people need a revision, especially with GERD. I didn't realize just how much it affected my sleep, eating, daily life until it went away. Such a relief to have it gone!

I wish you the best of luck in your surgery!

Thank you so much for sharing. As I am hearing more successes I am feeling more comfortable. I am less than a week away and just want start living my new normal life without reflux!

[Lorie269 392]

On 12/29/2022 at 7:09 AM, Tomo said:

I had it done about a year and a half ago (for gerd). All good, nothing negative to report, much easier recovery, much easier everything actually.

Oh this is music to my ears. I am having my revision to bypass done on 1/15. My sleeve recovery was as good as I could have imagined so I am hopefully the bypass will be as well.

[NotGivingUp2023 0]

I am curious the process people went through for Sleeve to Bypass? I've been seeing a gastroenterologist for pain, nausea, vomiting. I have had 2 EGD's, both show chronic inflammation and gastritis, due to reflux. My surgeon is sounding very reluctant to do this surgery. I did get down to 115 lbs and have put on 50 lbs since my lowest. He is blaming the reflux on the weight gain, but I was at my lowest, when the first EGD showed inflammation due to reflux.

He just ordered a barium swallow, and all came back normal. I am seeing the nutritionist, she said she spoke with the surgeon, and we would be going over the new pre-op diet, since it is different than the sleeve and has changed since I had the sleeve in 2019.

I am afraid he will refuse to do the surgery and I will be left with this pain, nausea and vomiting; I have been battling for almost 3 years, with no relief. My gastroenterologist is at his wits end and doesn't want to continue seeing me go through this. I wake up choking on acid, had tests run by my pulmonologist and cardiologist. My asthma had gone away but returned. The surgeon also blames that on the weight gain.

Pre-sleeve, I had walked 27,000 steps in a year. This year, I am at 1.7 million steps and ride a stationary bike 10-15 miles a day. This is huge for me, I have something called Pulmonary Arterial Hypertension. Pre-sleeve, I was knocking on deaths door. I only found this "terminal" illness, from my pre-op tests for the sleeve. Since the weight loss, I went from 6 months to live, to medication that has me at "normal/high" levels vs "high". My specialist is afraid the weight gain is spiraling and illness progressing. What changed for me, the medication I take for PAH, you have to consume 250-300 calories per dose with 30-50% fat content. Otherwise, you get violently ill. I take 3 doses a day. When I was diagnosed and first 2 years, I was on a CADD pump and that medication didn't have dietary requirements.

Sorry for the long story........I just can't take the reflux (even though the barium swallow does not show but EGD definitely does and has, in 3 different tests) and the weight gain is scaring me to death.

What was your process with your surgeons, going from sleeve to bypass? Is this a long process? Did you have a difficult time with insurance approval? Any suggestions on getting this done?

Your experience and help, is greatly appreciated!

Edited January 10, 2023 by NotGivingUp2023

[hayyouljkb 4]

24 minutes ago, NotGivingUp2023 said:

I am curious the process people went through for Sleeve to Bypass? I've been seeing a gastroenterologist for pain, nausea, vomiting. I have had 2 EGD's, both show chronic inflammation and gastritis, due to reflux. My surgeon is sounding very reluctant to do this surgery. I did get down to 115 lbs and have put on 50 lbs since my lowest. He is blaming the reflux on the weight gain, but I was at my lowest, when the first EGD showed inflammation due to reflux.

He just ordered a barium swallow, and all came back normal. I am seeing the nutritionist, she said she spoke with the surgeon, and we would be going over the new pre-op diet, since it is different than the sleeve and has changed since I had the sleeve in 2019.

I am afraid he will refuse to do the surgery and I will be left with this pain, nausea and vomiting; I have been battling for almost 3 years, with no relief. My gastroenterologist is at his wits end and doesn't want to continue seeing me go through this. I wake up choking on acid, had tests run by my pulmonologist and cardiologist. My asthma had gone away but returned. The surgeon also blames that on the weight gain.

Pre-sleeve, I had walked 27,000 steps in a year. This year, I am at 1.7 million steps and ride a stationary bike 10-15 a day. This is huge for me, I have something called Pulmonary Arterial Hypertension. Pre-sleeve, I was knocking on deaths door. I only found this "terminal" illness, from my pre-op tests for the sleeve. Since the weight loss, I went from 6 months to live, to medication that has me at "normal/high" levels vs "high". My specialist is afraid the weight gain is spiraling and illness progressing. What changed for me, the medication I take for PAH, you have to consume 250-300 calories per dose with 30-50% fat content. Otherwise, you get violently ill. I take 3 doses a day. When I was diagnosed and first 2 years, I was on a CADD pump and that medication didn't have dietary requirements.

Sorry for the long story........I just can't take the reflux (even though the barium swallow does not show but EGD definitely does and has, in 3 different tests) and the weight gain is scaring me to death.

What was your process with your surgeons, going from sleeve to bypass? Is this a long process? Did you have a difficult time with insurance approval? Any suggestions on getting this done?

Your experience and help, is greatly appreciated!

Hi! I am so sorry you are going through this. I am really surprised that your barium swallow test did not show anything if you are having such bad reflux.

All of this is so frustrating. You go through the first surgery thinking that everything will be just fine and then find out something else has to be done, and then you have to fight with insurances and Dr.'s just to help you. I am lucky, I have amazing Dr.'s who have fought, I just don't have an insurance who will help me.

I did not even know that the sleeve could cause reflux to get worse until I had a surgery consult in 2021. My reflux was slowly increasing since I was sleeved in 2015 and finally in 2020/2021 I could not take it any longer. Every night acid would come out of my nose, despite having an adjustable bed and practically sleeping sitting up, not eating or drinking 2-3 hours before bed. I was doing everything. I had an upper endoscopy that showed a hiatal hernia and I was referred to a surgeon. To my luck the surgeon was the leading bariatric surgeon in my region. He said that since I had the sleeve he could not fix my hernia that the only fix was to convert to the Bypass. I had no idea that was even an option, and he explained to me what was going on. I was blown away. He then sent me for the barium swallow. The radiologist said that she had never seen anyone with as bad reflux as I had. I refluxed the barium standing up! She had never seen that before. It was very clear what was needed and I was immediately fast-tracked through the Bariatric program since it had been so long since I had been through a program, and my first program was in a different area and through different insurance. Then came the brick wall. My insurance denied the surgery. They stated that my reflux was a complication from the first surgery, even though I had reflux prior to the surgery. I appealed and sent medical documentation to show I had reflux prior to the surgery and they still denied. I did 3 levels of appeal, and my surgeon also did a pier to pier review with the medical director with the insurance and they denied again. And I finally found out the real reason. I have my insurance through my husbands insurance through his work, and his company specifically excluded bariatric procedures, so bottom line, no matter the reason why I am getting the surgery they will not cover it because it is still coded as a bariatric surgery. And I have to now pay cash for the surgery. But it is worth it if it fixes the problem and I don't have to deal with the reflux!

However this is my experience with my insurance. I hope you don't have the same experience with your insurance.

Are there any other surgeons in your area? You are always free to get a second opinion. It is sad but sometimes you have to push Dr.'s to listen to you, and you have to be your own advocate and not wait for them. Please don't be afraid to fight for yourself and your health!!!

I would think that they would take into consideration the medication that you have to take, and the conditions that the reflux is already causing.

Good Luck!!!

[NotGivingUp2023 0]

6 minutes ago, hayyouljkb said:

Hi! I am so sorry you are going through this. I am really surprised that your barium swallow test did not show anything if you are having such bad reflux.

All of this is so frustrating. You go through the first surgery thinking that everything will be just fine and then find out something else has to be done, and then you have to fight with insurances and Dr.'s just to help you. I am lucky, I have amazing Dr.'s who have fought, I just don't have an insurance who will help me.

I did not even know that the sleeve could cause reflux to get worse until I had a surgery consult in 2021. My reflux was slowly increasing since I was sleeved in 2015 and finally in 2020/2021 I could not take it any longer. Every night acid would come out of my nose, despite having an adjustable bed and practically sleeping sitting up, not eating or drinking 2-3 hours before bed. I was doing everything. I had an upper endoscopy that showed a hiatal hernia and I was referred to a surgeon. To my luck the surgeon was the leading bariatric surgeon in my region. He said that since I had the sleeve he could not fix my hernia that the only fix was to convert to the Bypass. I had no idea that was even an option, and he explained to me what was going on. I was blown away. He then sent me for the barium swallow. The radiologist said that she had never seen anyone with as bad reflux as I had. I refluxed the barium standing up! She had never seen that before. It was very clear what was needed and I was immediately fast-tracked through the Bariatric program since it had been so long since I had been through a program, and my first program was in a different area and through different insurance. Then came the brick wall. My insurance denied the surgery. They stated that my reflux was a complication from the first surgery, even though I had reflux prior to the surgery. I appealed and sent medical documentation to show I had reflux prior to the surgery and they still denied. I did 3 levels of appeal, and my surgeon also did a pier to pier review with the medical director with the insurance and they denied again. And I finally found out the real reason. I have my insurance through my husbands insurance through his work, and his company specifically excluded bariatric procedures, so bottom line, no matter the reason why I am getting the surgery they will not cover it because it is still coded as a bariatric surgery. And I have to now pay cash for the surgery. But it is worth it if it fixes the problem and I don't have to deal with the reflux!

However this is my experience with my insurance. I hope you don't have the same experience with your insurance.

Are there any other surgeons in your area? You are always free to get a second opinion. It is sad but sometimes you have to push Dr.'s to listen to you, and you have to be your own advocate and not wait for them. Please don't be afraid to fight for yourself and your health!!!

I would think that they would take into consideration the medication that you have to take, and the conditions that the reflux is already causing.

Good Luck!!!

I am so sorry you're dealing with this, as well! It just doesn't seem acceptable, just the hernia and reflux alone, is reason enough! Are you staying local to you or going to Mexico? I've read a lot of people going that route.

I did see another surgeon, a televisit. They took the time to review my medical history, before talking to me. They also called my insurance. Insurance will approve, depending on the circumstances. I doubt regain is one of them but that is the least of my worries, right now. However, this surgeon did not feel comfortable with my pulmonary arterial hypertension, to perform surgery. I go through this ALL the time! Never had an issue with surgery and my specialist says he has no issues, but Dr's hear that diagnosis and freak out!

I don't understand how the barium swallow doesn't show the reflux, either but an endoscopy and biopsy are much more reliable than an X-ray. If this Dr. has no intentions on moving forward, I will definitely have to find someone else, I just figured I would go with the associate of my original procedure. My surgeon actually left the state.

At least I will have the EGD's done, barium swallow, just had pulmonary tests done, EKG/ECG, complete blood panel and see the nutritionist Thursday. My insurance runs April-April, so I was hoping to get this done before the new year begins. I just wasn't sure if this is as extensive as the first surgery. That took a good 6 months to get through.

I wish you all the best! I know how bad reflux is, I have battled this since my late 20's but not to the point that I risk aspirating in my sleep. It is far too dangerous for me.

[CeciliaInPNW 7]

3 hours ago, NotGivingUp2023 said:

I am curious the process people went through for Sleeve to Bypass? I've been seeing a gastroenterologist for pain, nausea, vomiting. I have had 2 EGD's, both show chronic inflammation and gastritis, due to reflux. My surgeon is sounding very reluctant to do this surgery. I did get down to 115 lbs and have put on 50 lbs since my lowest. He is blaming the reflux on the weight gain, but I was at my lowest, when the first EGD showed inflammation due to reflux.

He just ordered a barium swallow, and all came back normal. I am seeing the nutritionist, she said she spoke with the surgeon, and we would be going over the new pre-op diet, since it is different than the sleeve and has changed since I had the sleeve in 2019.

I am afraid he will refuse to do the surgery and I will be left with this pain, nausea and vomiting; I have been battling for almost 3 years, with no relief. My gastroenterologist is at his wits end and doesn't want to continue seeing me go through this. I wake up choking on acid, had tests run by my pulmonologist and cardiologist. My asthma had gone away but returned. The surgeon also blames that on the weight gain.

Pre-sleeve, I had walked 27,000 steps in a year. This year, I am at 1.7 million steps and ride a stationary bike 10-15 miles a day. This is huge for me, I have something called Pulmonary Arterial Hypertension. Pre-sleeve, I was knocking on deaths door. I only found this "terminal" illness, from my pre-op tests for the sleeve. Since the weight loss, I went from 6 months to live, to medication that has me at "normal/high" levels vs "high". My specialist is afraid the weight gain is spiraling and illness progressing. What changed for me, the medication I take for PAH, you have to consume 250-300 calories per dose with 30-50% fat content. Otherwise, you get violently ill. I take 3 doses a day. When I was diagnosed and first 2 years, I was on a CADD pump and that medication didn't have dietary requirements.

Sorry for the long story........I just can't take the reflux (even though the barium swallow does not show but EGD definitely does and has, in 3 different tests) and the weight gain is scaring me to death.

What was your process with your surgeons, going from sleeve to bypass? Is this a long process? Did you have a difficult time with insurance approval? Any suggestions on getting this done?

Your experience and help, is greatly appreciated!

I had an upper endoscopy which showed esophagitis resulting from the GERD/reflux. I had been waking up with acid in my throat at night and was basically eating a very high Fiber diet since fiber didn’t elevate my reflux. I had regained weight. I had to appeal my insurance three times to get them to approve my hiatal hernia repair and revision to bypass. My insurance spelled out the 6 or so reasons they would approve the bypass and I qualified for 1 of them (esophagitis). I had already been under the care of my doctors dietician since my sleeve (I continued to see her under my insurance after the first year that was included in my surgery package) so I did not have to do any further diet monitoring, and the process went pretty quickly. Just the few months it’s took for the insurance appeals.