Our Summary

This study looked at the prevalence and risk factors of gastroesophageal reflux disease (GERD) in patients who underwent a type of weight loss surgery called Roux-en-Y gastric bypass (RYGB). GERD is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach, causing symptoms like heartburn. It’s more common in people with obesity, but RYGB surgery can help control both obesity and GERD.

In this study, 180 patients who had RYGB surgery were followed for an average of 12.2 years. The average age of the patients before surgery was about 43 years, and they had an average body mass index (BMI) of 45.2, which is considered obese. More than 70% of the patients were women, and 41.1% had GERD before surgery.

At the 12-year follow-up, the patients had an average weight loss of about 60% of their excess body weight and 25.73% of their total weight. However, nearly 24% of the patients had GERD after surgery. Of these, 40% had persistent GERD symptoms, and 60% developed new GERD symptoms after surgery.

The study also found that the patients’ scores on GERD-related quality of life, eating behaviors, and gastrointestinal symptom rating scales changed after surgery. The GERD quality of life score improved, while the scores for diarrhea and indigestion symptoms increased. The scores for uncontrolled eating and emotional eating behaviors decreased.

The study concluded that RYGB surgery was effective in controlling GERD, but about 24% of the patients had persistent or new GERD symptoms 12 years after surgery. The risk factors for GERD after RYGB surgery were weight regain and diarrhea symptoms.

FAQs

  1. What is the prevalence of GERD in patients after undergoing RYGB surgery?
  2. What were the identified risk factors for GERD after RYGB surgery?
  3. How did RYGB surgery affect GERD-related quality of life, eating behaviors, and gastrointestinal symptoms?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric bypass surgery is to follow a healthy diet and lifestyle after surgery to help prevent or manage GERD symptoms. This can include eating smaller meals, avoiding trigger foods that can worsen GERD, staying upright after eating, and maintaining a healthy weight. It’s also important to follow up with your healthcare team regularly for monitoring and support. If you experience persistent or new GERD symptoms after surgery, be sure to discuss them with your healthcare provider for further evaluation and management.

Suitable For

Patients who are typically recommended for gastric bypass surgery, such as Roux-en-Y gastric bypass, are those who are severely obese with a BMI of 40 or higher, or those with a BMI of 35 or higher with obesity-related health conditions such as GERD, diabetes, hypertension, or sleep apnea. Additionally, patients who have not been successful with other weight loss methods such as diet and exercise may also be recommended for gastric bypass surgery. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are a suitable candidate for gastric bypass surgery.

Timeline

Overall, the timeline of a patient before and after gastric bypass surgery can be summarized as follows:

Before surgery:

  • Patient is obese with a high BMI
  • Patient may have GERD symptoms
  • Patient undergoes RYGB surgery

After surgery:

  • Patient experiences significant weight loss
  • Patient may have improved quality of life related to GERD
  • Some patients may still have GERD symptoms, with risk factors including weight regain and diarrhea symptoms
  • Changes in eating behaviors and gastrointestinal symptoms may occur

In conclusion, while RYGB surgery can be effective in controlling obesity and GERD, it is important for patients to be aware of the potential risks and changes in symptoms that may occur after surgery. Regular follow-ups and monitoring are essential for long-term success and management of GERD in patients who undergo gastric bypass surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications of gastric bypass surgery, including the development or worsening of gastroesophageal reflux disease (GERD)?

  2. How will my GERD symptoms be monitored and managed after surgery?

  3. What lifestyle changes or medications may be recommended to help prevent or manage GERD after gastric bypass surgery?

  4. What is the likelihood of developing GERD after surgery, and what factors may increase my risk?

  5. How long after surgery should I expect to see improvements in my GERD symptoms, if I had them before surgery?

  6. Are there any specific dietary guidelines or restrictions I should follow to help prevent GERD after surgery?

  7. How often should I follow up with my healthcare provider to monitor for GERD symptoms and overall digestive health after gastric bypass surgery?

  8. Are there any alternative treatments or procedures that may be considered if GERD symptoms persist or worsen after surgery?

  9. How does weight regain or changes in eating behaviors after surgery impact the risk of developing or worsening GERD symptoms?

  10. Can you provide me with resources or support groups for patients who have undergone gastric bypass surgery and may be experiencing GERD symptoms?

Reference

Authors: Pažusis M, Gerasimovič G, Petereit R, Gudaitytė R, Maleckas A. Journal: Medicina (Kaunas). 2024 Jul 28;60(8):1221. doi: 10.3390/medicina60081221. PMID: 39202502