Our Summary

This study investigated why some people experience persistent or new-onset acid reflux after a specific type of weight-loss surgery called sleeve gastrectomy (SG) more often than after another type, Roux-en-Y gastric bypass (RYGB).

To do this, researchers used high-resolution manometry (HRM), a technique that measures pressure in the stomach and esophagus, and pH-impedance monitoring, a method to evaluate acid and non-acid reflux, in patients who had undergone these two surgeries, patients with reflux symptoms, and healthy controls.

They found that patients who had undergone the SG surgery had higher acid exposure time (AET), more episodes of reflux, and higher baseline pressure inside the stomach compared to those who had undergone the RYGB surgery. SG patients also had lower pressure across the esophagogastric junction (EGJ), the area where the esophagus and stomach meet, especially when they had a high number of reflux episodes or high AET.

In simple terms, after SG surgery, the stomach is more pressurized and the barrier function of the EGJ is impaired, leading to more acid reflux, especially during straining activities.

FAQs

  1. Why do some people experience more acid reflux after sleeve gastrectomy (SG) surgery compared to Roux-en-Y gastric bypass (RYGB) surgery?
  2. What techniques did the researchers use to measure acid reflux and pressure in the stomach and esophagus?
  3. What were the main findings of the study in relation to acid reflux after SG and RYGB surgeries?

Doctor’s Tip

Therefore, a doctor might advise a patient who has undergone gastric sleeve surgery to avoid straining activities, such as heavy lifting or intense exercise, to help reduce the risk of acid reflux. They may also recommend certain dietary changes, such as avoiding spicy or acidic foods, eating smaller meals more frequently, and chewing food thoroughly to aid digestion and prevent reflux symptoms. Additionally, taking medications as prescribed by the doctor to manage acid reflux symptoms may also be necessary. It is important for patients to follow their doctor’s recommendations and attend regular follow-up appointments to monitor their progress and address any concerns.

Suitable For

Therefore, patients who are recommended for gastric sleeve surgery are typically those who are obese and have not been successful with other weight loss methods. They should also have a BMI over 40, or a BMI over 35 with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. Additionally, patients should be committed to making lifestyle changes and willing to follow a strict diet and exercise plan after surgery.

Timeline

Before gastric sleeve surgery, a patient will typically undergo a series of consultations with a healthcare provider to determine if they are a good candidate for the procedure. They may also need to undergo various tests and evaluations to assess their overall health and readiness for surgery.

After gastric sleeve surgery, the patient will need to follow a strict post-operative diet and exercise regimen to aid in recovery and weight loss. They will also have regular follow-up appointments with their healthcare provider to monitor their progress and address any concerns or complications that may arise.

Over time, the patient can expect to experience significant weight loss and improvements in their overall health and quality of life. They may also need to make long-term lifestyle changes, such as maintaining a healthy diet and exercise routine, to ensure the success of the surgery and prevent weight regain.

It is important for patients to be aware of potential risks and complications associated with gastric sleeve surgery, such as acid reflux, and to work closely with their healthcare provider to address any issues that may arise.

What to Ask Your Doctor

Some questions a patient should ask their doctor about gastric sleeve surgery in relation to acid reflux symptoms may include:

  1. What is the likelihood of experiencing acid reflux after undergoing a gastric sleeve surgery compared to other weight-loss surgeries?
  2. What specific factors during the surgery may contribute to a higher risk of acid reflux?
  3. How can acid reflux symptoms be managed or treated after undergoing a gastric sleeve surgery?
  4. Are there any lifestyle changes or dietary modifications that can help reduce the risk of acid reflux following the surgery?
  5. Should I undergo any additional tests or monitoring for acid reflux after the surgery?
  6. Are there any medications or treatments that can be prescribed to alleviate acid reflux symptoms post-surgery?
  7. How long do acid reflux symptoms typically last after gastric sleeve surgery, and are there any long-term implications to be aware of?
  8. Are there any warning signs or symptoms that I should watch for that may indicate a more serious issue related to acid reflux after the surgery?
  9. How often should I follow up with my healthcare provider to monitor and address any acid reflux symptoms post-surgery?
  10. Is there any additional information or resources available to help me better understand and manage acid reflux after undergoing a gastric sleeve surgery?

Reference

Authors: Greenan G, Rogers BD, Gyawali CP. Journal: Am J Gastroenterol. 2023 Dec 1;118(12):2148-2156. doi: 10.14309/ajg.0000000000002374. Epub 2023 Jun 19. PMID: 37335154