Our Summary

This research paper discusses the connection between obesity, a common condition known as GERD (which is when stomach acid frequently flows back into the tube connecting your mouth and stomach), and a weight loss surgery called bariatric surgery. The paper explains that while this surgery can often help improve GERD in obese individuals, in some cases, it can actually make GERD worse or even cause it. This is particularly common in patients who undergo a specific type of this surgery called a sleeve gastrectomy.

The paper notes that GERD can have a significant impact on patients’ lives, affecting not only their physical health but also their mental and emotional wellbeing, and social interactions. The causes of GERD after a sleeve gastrectomy are likely diverse, with possible factors including the shape of the stomach after surgery, damage to the muscle at the bottom of the esophagus, and the presence of a type of hernia that affects the upper part of the stomach.

The research suggests that in order to effectively treat GERD after a sleeve gastrectomy, doctors need to first identify the cause of the problem. The treatments can then range from changes in lifestyle and medication, to more invasive procedures or even additional surgery.

FAQs

  1. Can bariatric surgery worsen or cause new onset of GERD?
  2. What are the potential causes of GERD after having a sleeve gastrectomy?
  3. What are the possible treatment options for post-sleeve gastrectomy GERD?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastric sleeve surgery is to be mindful of their dietary habits and portion sizes post-surgery. It is important for patients to follow a balanced and healthy diet, eat smaller meals more frequently, and avoid overeating or consuming high-fat and high-sugar foods. This can help prevent complications such as acid reflux or GERD after the surgery. Additionally, staying hydrated and avoiding carbonated beverages can also help alleviate symptoms of GERD. It is important for patients to follow their doctor’s recommendations and attend follow-up appointments to ensure a successful recovery and maintain their overall health.

Suitable For

Patients who are typically recommended for gastric sleeve surgery are those who have a body mass index (BMI) of 40 or higher (severe obesity) or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. Patients who have not been successful with other weight loss methods such as diet and exercise may also be recommended for gastric sleeve surgery. Additionally, patients who are motivated and willing to make lifestyle changes post-surgery are good candidates for this procedure.

Timeline

  1. Pre-surgery:
  • Patient consults with a bariatric surgeon and undergoes medical evaluation.
  • Patient may need to undergo pre-operative tests and assessments to determine eligibility for surgery.
  • Patient receives pre-operative counseling and education on the procedure, risks, and lifestyle changes required post-surgery.
  1. Surgery:
  • Patient undergoes sleeve gastrectomy surgery, where a portion of the stomach is removed to create a smaller sleeve-shaped stomach.
  • Surgery typically lasts for 1-2 hours and is performed laparoscopically.
  • Patient may stay in the hospital for 1-2 days post-surgery for monitoring and recovery.
  1. Post-surgery:
  • Patient follows a strict liquid and pureed diet for the first few weeks post-surgery, gradually transitioning to solid foods.
  • Patient is required to make significant lifestyle changes, including adopting a healthy diet and regular exercise routine.
  • Patient attends follow-up appointments with the bariatric team for monitoring and support.
  • Patient may experience rapid weight loss in the first few months post-surgery.
  1. GERD symptoms:
  • Some patients may experience improvement in GERD symptoms post-surgery due to weight loss.
  • However, some patients may experience worsening or new onset of GERD symptoms after sleeve gastrectomy.
  • Symptoms may include heartburn, regurgitation, chest pain, and difficulty swallowing.
  1. Treatment:
  • Patients experiencing GERD post-sleeve gastrectomy may require lifestyle modifications, such as avoiding trigger foods and elevating the head of the bed while sleeping.
  • Medications, such as proton pump inhibitors, may be prescribed to manage GERD symptoms.
  • In severe cases, interventional treatments or revisional surgery may be necessary to address GERD.

Overall, the timeline of a patient’s experience before and after gastric sleeve surgery involves thorough pre-operative preparation, surgical intervention, post-operative recovery, and ongoing management of potential complications, such as GERD.

What to Ask Your Doctor

  1. What are the potential risks and complications of gastric sleeve surgery, including the development or worsening of GERD?
  2. How will the surgery impact my current GERD symptoms, if any?
  3. What measures will be taken during surgery to minimize the risk of developing GERD post-operatively?
  4. What lifestyle changes will I need to make post-surgery to help manage or prevent GERD symptoms?
  5. What medications may be prescribed to help with GERD symptoms after surgery?
  6. If my GERD symptoms worsen after surgery, what treatment options are available to me?
  7. How often will I need follow-up appointments to monitor for GERD symptoms after surgery?
  8. Are there any specific dietary recommendations I should follow to help prevent GERD after surgery?
  9. If revisional surgery is needed to address GERD after gastric sleeve, what does that process entail?
  10. Are there any specific symptoms I should watch out for that may indicate the development or worsening of GERD after surgery?

Reference

Authors: Felinska E, Billeter A, Nickel F, Contin P, Berlth F, Chand B, Grimminger P, Mikami D, Schoppmann SF, Müller-Stich B. Journal: Ann N Y Acad Sci. 2020 Dec;1482(1):26-35. doi: 10.1111/nyas.14467. Epub 2020 Sep 6. PMID: 32893342