acid reflux and the VSG
IF YOU HAVE GERD AND ARE CONSIDERING VSG, PLEASE READ THIS: I am 18 mos. post op, and achieved my goal weight within 12 mos. What I did not count on was a complication related to the GERD I had before the VSG. I had been on Prilosec for approx. 1 year prior to considering VSG. Everything I read led me to believe that losing weight would most likely end my problems with acid reflux. What my surgeon now tells me is that they now know some patients develop more intense acid reflux after the VSG.
As I approached my goal weight and my acid problems worsened, I consulted my doctor, who ordered an endoscopy. I was shocked to discover I had Barrett's Esophogus, a disease which is considered pre-cancerous, and which, if left untreated, could turn into esophogeal cancer. Lymph nodes are very close to the esophogus, so if you get dysplasia (changes in the cells), you're probably not going to be buying any green bananas, if you get my drift.
The only way to conclusively diagnose Barrett's is with biopsy done during endoscopy. I did not have endoscopy prior to the VSG, so I do not know if there would have been a finding of Barrett's prior to the VSG, but I can tell you that had I known then what I know now, I would have proceeded differently.
One of the most successful ways of treating GERD has been a procedure called fundiplication - a procedure which is no logner an option once you have had VSG. For more information about this procedure you can check out Esophyx at Laproscopic Associates of San Francisco, done by Dr. Cirangle.
Don't get me wrong. I'm happy about my weight loss. I just didn't consider the prospects of being on acid-reducing medication the rest of my life. (There are some problems with long-term use of acid-blockers - one study shows less calcium absorption.) I sure as heck didn't expect to find my acid problems worsening after surgery and weight loss.
Here's the thing though: I had never heard of anyone having MORE acid reflux after a VSG and subsequent weight loss. My doctor, however, had.
As I approached my goal weight and my acid problems worsened, I consulted my doctor, who ordered an endoscopy. I was shocked to discover I had Barrett's Esophogus, a disease which is considered pre-cancerous, and which, if left untreated, could turn into esophogeal cancer. Lymph nodes are very close to the esophogus, so if you get dysplasia (changes in the cells), you're probably not going to be buying any green bananas, if you get my drift.
The only way to conclusively diagnose Barrett's is with biopsy done during endoscopy. I did not have endoscopy prior to the VSG, so I do not know if there would have been a finding of Barrett's prior to the VSG, but I can tell you that had I known then what I know now, I would have proceeded differently.
One of the most successful ways of treating GERD has been a procedure called fundiplication - a procedure which is no logner an option once you have had VSG. For more information about this procedure you can check out Esophyx at Laproscopic Associates of San Francisco, done by Dr. Cirangle.
Don't get me wrong. I'm happy about my weight loss. I just didn't consider the prospects of being on acid-reducing medication the rest of my life. (There are some problems with long-term use of acid-blockers - one study shows less calcium absorption.) I sure as heck didn't expect to find my acid problems worsening after surgery and weight loss.
Here's the thing though: I had never heard of anyone having MORE acid reflux after a VSG and subsequent weight loss. My doctor, however, had.
i am very sorry that you are having to go through this, when you had your surgery did you have a hiatal hernia repair??
it was noted when i had my upper Gi as part of my tests for my surgeon that i have a hiatal hernia and will be speaking to the surgeon and asking that they repair it when i go in for my pre op. because if its not repaired now i am aware that it is something that i can not have done at a later stage
it was noted when i had my upper Gi as part of my tests for my surgeon that i have a hiatal hernia and will be speaking to the surgeon and asking that they repair it when i go in for my pre op. because if its not repaired now i am aware that it is something that i can not have done at a later stage
Linda 5".4
6lbs under goal weight
Join US On The VSG Maintenance Group Forum!!
http://www.obesityhelp.com/group/VSGM/discussion/
6lbs under goal weight
Join US On The VSG Maintenance Group Forum!!
http://www.obesityhelp.com/group/VSGM/discussion/
Thank you so much for posting this. I am 16 months out and woke up (again) last night choking on acid. So scary. Your post is a wake up call for me. I am on two Prilosecs OTC a day.
After reading your post, I believe I will call my PCP TODAY and find out what is going on.
P.S. I never had acid problems before VSG.
Brooke K
After reading your post, I believe I will call my PCP TODAY and find out what is going on.
P.S. I never had acid problems before VSG.
Brooke K
I am 5'4" tall
I'm so sorry you're going through all this, and hope that everything works out.
Developing GERD (or it getting worse if you've already got it) is one of the most common side effects of the sleeve. I'm very surprised you weren't made aware of this before surgery, and also that you didn't have to have an endoscopy. GERD is one of the most discussed topics on this board, it seems like. Weird that your doctor didn't bring it up.
MM
Developing GERD (or it getting worse if you've already got it) is one of the most common side effects of the sleeve. I'm very surprised you weren't made aware of this before surgery, and also that you didn't have to have an endoscopy. GERD is one of the most discussed topics on this board, it seems like. Weird that your doctor didn't bring it up.
MM
I got the GERD too :) mmmm acid in mouth...
I take prevacid every day. Works great for the most part. I just take extra calcium.
I gotta tell you - I will happily trade gerd, being on PPIs and taking extra vits for being obese.
And don't forget obesity has it's own scary side-effects. Including higher cancer rates, heart disease, alzheimers, diabetes, you name it.
I take prevacid every day. Works great for the most part. I just take extra calcium.
I gotta tell you - I will happily trade gerd, being on PPIs and taking extra vits for being obese.
And don't forget obesity has it's own scary side-effects. Including higher cancer rates, heart disease, alzheimers, diabetes, you name it.
HW: 225 | SW: 198 | CW: 123 | Height: 5' 7.5" I LOVE MY SLEEVE!!
13 lbs below goal :)
13 lbs below goal :)
Hi, Mendolori,
I feel for you as I have had much the same experience. Do you have a hiatal hernia? You can have surgery to repair it without Esophyx. As you mention, it's not the traditional fundoplication because in that surgery, part of the stomach is wrapped around the esophagus to keep the stomach from coming back up--and we no longer have the stomach! However, Dr. Jossart (LapSF) did a second surgery on me to fix my hiatal hernia and instead of wrapping the stomach, he makes a small stitch to keep it in place. This surgery is endoscopic like the sleeve and was totally covered by my insurance. Unfortunately, while my hiatal hernia is repaired, my acid problems remain because my esophageal sphincter doesn't work well and remains open, allowing the acid, etc. to go up into the esophagus. Dr. Jossart (who also does the Esophyx surgery) now recommends that procedure as my best option. It's not yet covered by insurance but he anticipates that it will be within a year or so. Anyway, my point is that if you have a hiatal hernia (and not also a problem with the sphincter), you can have a fairly traditional surgery to fix it.
I too am not happy with having to take a double dose of PPI indefinitely, though I don't for an instant regret my decision to have the sleeve. I think my health problems would be way worse with the extra weight.
Hang in there!
Lizanne
I feel for you as I have had much the same experience. Do you have a hiatal hernia? You can have surgery to repair it without Esophyx. As you mention, it's not the traditional fundoplication because in that surgery, part of the stomach is wrapped around the esophagus to keep the stomach from coming back up--and we no longer have the stomach! However, Dr. Jossart (LapSF) did a second surgery on me to fix my hiatal hernia and instead of wrapping the stomach, he makes a small stitch to keep it in place. This surgery is endoscopic like the sleeve and was totally covered by my insurance. Unfortunately, while my hiatal hernia is repaired, my acid problems remain because my esophageal sphincter doesn't work well and remains open, allowing the acid, etc. to go up into the esophagus. Dr. Jossart (who also does the Esophyx surgery) now recommends that procedure as my best option. It's not yet covered by insurance but he anticipates that it will be within a year or so. Anyway, my point is that if you have a hiatal hernia (and not also a problem with the sphincter), you can have a fairly traditional surgery to fix it.
I too am not happy with having to take a double dose of PPI indefinitely, though I don't for an instant regret my decision to have the sleeve. I think my health problems would be way worse with the extra weight.
Hang in there!
Lizanne
Knew about this going in, didn't care. I'd given up on ever losing weight again. Had the sleeve and couldn't be happier.
One thing through. The hospital gave me Controloc as a PPI. Heard Nexium was the bomb and switched to that. Within days I was getting horrible feelings of nausea and I was very aware of my stomach. Just a few hours ago I got my hands on Controloc again and all is now well. Don't know what they put in or left out, but those little differences make all the difference.
One thing through. The hospital gave me Controloc as a PPI. Heard Nexium was the bomb and switched to that. Within days I was getting horrible feelings of nausea and I was very aware of my stomach. Just a few hours ago I got my hands on Controloc again and all is now well. Don't know what they put in or left out, but those little differences make all the difference.
When a true genius appears in the world, you may know him by this sign: that the dunces are all in confederacy against him. 
Have you ever tried a gluten-free diet? Our youngest daughter has Down syndrome, and she was diagnosed with Celiac Disease last year. It turns out that people with DS have a 1-in-8 chance of developing CD in their lifetime. A HUGE number of children with DS have issues with GERD and end up having to have a Nissen fundiplication and a g-tube for feeding. It is entirely possible that these children actually have CD and/or gluten sensitivity.
You may want to ask your doctor to do a screen for Celiac Disease, and then try a gluten-free diet for a month or two, just to see if it makes your GERD better - many people find that it does, indeed, help. What most doctors don't know is that CD is much more common than originally believed - up to 1% of the US population has it, yet only 3% of them have been diagnosed.
You can go to www.celiac.com for more information - while the site is most helpful for people who have been diagnosed with CD, it has good information about a GFD as well as other health conditions that can be associated with gluten issues. There is also a list of symptoms that you may find helpful.
Please feel free to PM me if you have any questions - I was diagnosed with CD a few months after my daughter, and I feel SO much better on a GFD (I never had any GI issues, however)!
Teresa Koch
Fort Worth, Texas
You may want to ask your doctor to do a screen for Celiac Disease, and then try a gluten-free diet for a month or two, just to see if it makes your GERD better - many people find that it does, indeed, help. What most doctors don't know is that CD is much more common than originally believed - up to 1% of the US population has it, yet only 3% of them have been diagnosed.
You can go to www.celiac.com for more information - while the site is most helpful for people who have been diagnosed with CD, it has good information about a GFD as well as other health conditions that can be associated with gluten issues. There is also a list of symptoms that you may find helpful.
Please feel free to PM me if you have any questions - I was diagnosed with CD a few months after my daughter, and I feel SO much better on a GFD (I never had any GI issues, however)!
Teresa Koch
Fort Worth, Texas
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