Our Summary

Obesity is a growing health concern worldwide and it is linked to an increase in GERD (a chronic digestive disorder where stomach acid frequently flows back into the esophagus). The paper discusses different treatment options for obesity, but emphasizes that bariatric surgery (weight loss surgery) has been the most effective. This surgery can help with sustained weight loss and decrease obesity-related complications and mortality.

However, the study also points out that different types of bariatric surgeries can lead to complications such as GERD and erosive esophagitis (inflammation, irritation or swelling of the esophagus). The types of bariatric surgeries discussed include laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG), and Roux-en-Y gastric bypass (RYGB).

From the research, it is found that RYGB can actually improve GERD symptoms and some weight loss surgeries even had to be converted to RYGB due to persistent reflux symptoms. On the other hand, while LAGB initially shows good results, some patients develop new reflux symptoms over time.

Lastly, the paper mentions that LSG has become a popular weight loss surgery but there are concerns as some studies show a high risk of GERD following this procedure. The article reviews these results and the mechanisms that cause GERD in severely obese individuals.

FAQs

  1. What is the most effective treatment for obesity according to the study?
  2. What are the possible complications of bariatric surgeries?
  3. How do different types of bariatric surgeries impact GERD symptoms?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to closely follow post-operative instructions provided by the surgeon and medical team. This may include dietary guidelines, medication management, physical activity recommendations, and follow-up appointments. It is important to adhere to these instructions to optimize recovery and minimize complications such as GERD. Additionally, it is important to communicate any new or worsening symptoms to your healthcare provider promptly.

Suitable For

Overall, patients who are severely obese and have GERD or other related complications may be recommended gastrectomy, specifically Roux-en-Y gastric bypass, as it has shown to improve GERD symptoms. However, it is important for healthcare providers to carefully consider the potential risks and benefits of each type of bariatric surgery before recommending gastrectomy to patients.

Timeline

Before gastrectomy:

  1. Patient may experience obesity-related complications such as GERD, erosive esophagitis, and other health issues.
  2. Patient may undergo evaluation and consultation with a healthcare provider to discuss treatment options for obesity, including bariatric surgery.
  3. Patient may undergo pre-operative preparation, including consultations with a nutritionist, psychologist, and other healthcare professionals.

After gastrectomy:

  1. Patient undergoes gastrectomy surgery, such as LAGB, LSG, or RYGB, to promote weight loss and improve obesity-related health issues.
  2. Patient may experience initial improvement in weight loss and obesity-related symptoms after surgery.
  3. Patient is monitored post-operatively for complications, including GERD and erosive esophagitis.
  4. Some patients may require conversion to RYGB due to persistent reflux symptoms.
  5. Long-term follow-up is important to monitor for the development of new reflux symptoms or other complications following gastrectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastrectomy surgery for weight loss?

  2. How does gastrectomy surgery affect GERD symptoms? Will the surgery improve or worsen my GERD symptoms?

  3. What is the success rate of gastrectomy surgery in terms of sustained weight loss and improvement in obesity-related complications?

  4. How long is the recovery process after gastrectomy surgery and what can I expect in terms of post-operative care and follow-up appointments?

  5. Are there any lifestyle changes or dietary guidelines I should follow before and after gastrectomy surgery to optimize my outcomes?

  6. Will I need to take any medications or supplements after gastrectomy surgery to support my nutritional needs?

  7. What are the long-term effects of gastrectomy surgery on my overall health and well-being?

  8. Are there any specific factors in my medical history or current health status that may affect the success of gastrectomy surgery for weight loss?

  9. How often will I need to follow up with you or a specialist after gastrectomy surgery to monitor my progress and address any concerns or complications that may arise?

  10. Can you provide me with more information about the different types of bariatric surgeries available, including the laparoscopic adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass, and help me understand which option may be best for me based on my individual health needs and goals?

Reference

Authors: Popescu AL, Ioniţa-Radu F, Jinga M, Gavrilă AI, Săvulescu FA, Fierbinţeanu-Braticevici C. Journal: Rom J Intern Med. 2018 Dec 1;56(4):227-232. doi: 10.2478/rjim-2018-0019. PMID: 30521478