Our Summary

Gastroesophageal reflux disease (GERD), commonly known as acid reflux, often occurs in people who are obese due to increased pressure in the abdomen and chest. One way to treat GERD is through weight loss. A type of surgery known as fundoplication is usually the best option to treat GERD, but it’s not always effective in extremely obese individuals.

Another type of surgery, called Roux-en-Y gastric bypass (RYGB), not only helps with severe obesity but also improves GERD in a big way through various processes, including weight loss. For this reason, many consider RYGB the top choice for treating patients who are severely obese and also have GERD.

However, not all patients are completely free from GERD symptoms after this surgery, which presents a treatment challenge. This review discusses the complicated relationship between obesity, GERD, and the RYGB surgery.

FAQs

  1. What is the relationship between obesity, GERD, and Roux-en-Y gastric bypass surgery?
  2. Is Roux-en-Y gastric bypass surgery an effective treatment for GERD in severely obese individuals?
  3. Do all patients experience relief from GERD symptoms after Roux-en-Y gastric bypass surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about obesity surgery, specifically Roux-en-Y gastric bypass (RYGB), is to be aware that while RYGB is a widely used bariatric procedure that can result in major improvement of gastroesophageal reflux disease (GERD), not all patients are completely free from GERD symptoms after the surgery. It is important for patients to communicate any ongoing symptoms to their healthcare provider so that appropriate management and follow-up care can be provided.

Suitable For

Patients who are typically recommended obesity surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes, high blood pressure, sleep apnea, or gastroesophageal reflux disease (GERD). Patients who have not been successful with other weight loss methods, such as diet and exercise, may also be recommended for obesity surgery. Additionally, patients who are motivated and committed to making lifestyle changes following surgery are good candidates for obesity surgery.

Timeline

Before obesity surgery:

  1. Patient consults with a bariatric surgeon to discuss surgical options for weight loss.
  2. Patient undergoes a series of evaluations, including physical exams, blood tests, and possibly psychological evaluations, to determine if they are a candidate for surgery.
  3. Patient may be required to participate in a pre-operative weight loss program to prepare for surgery.
  4. Patient discusses potential risks and benefits of surgery with their healthcare team and makes an informed decision.

After obesity surgery:

  1. Patient undergoes the surgical procedure, such as Roux-en-Y gastric bypass (RYGB).
  2. Patient stays in the hospital for a few days to recover from surgery.
  3. Patient follows a strict post-operative diet and exercise regimen to promote weight loss and prevent complications.
  4. Patient attends regular follow-up appointments with their healthcare team to monitor their progress and address any concerns.
  5. Patient experiences significant weight loss and improvement in obesity-related health issues, such as gastroesophageal reflux disease (GERD).
  6. Patient may still experience GERD symptoms after surgery, requiring ongoing management and treatment.

What to Ask Your Doctor

Here are some questions a patient may consider asking their doctor about obesity surgery:

  1. What are the potential risks and complications associated with obesity surgery?
  2. How does obesity surgery specifically impact gastroesophageal reflux disease (GERD)?
  3. What are the success rates of obesity surgery in improving GERD symptoms?
  4. Is Roux-en-Y gastric bypass (RYGB) the best surgical option for treating both severe obesity and GERD?
  5. What lifestyle changes will I need to make after undergoing obesity surgery to maintain results?
  6. How long is the recovery process after obesity surgery, and when can I expect to resume normal activities?
  7. Are there any dietary restrictions or guidelines I should follow post-surgery?
  8. Will I need to take any medications or supplements after undergoing obesity surgery?
  9. How often will I need to follow up with my doctor after the surgery?
  10. What are the long-term effects of obesity surgery on overall health and well-being?

Reference

Authors: Suter M. Journal: Obes Surg. 2020 Aug;30(8):3178-3187. doi: 10.1007/s11695-020-04690-2. PMID: 32424794