I'm glad to see they're taking an evidence-based approach to this, and finding patterns in the root causes for reflux post-op.
The data on the extent of the problem are not conclusive. There's just as much literature saying reflux gets worse as saying reflux gets better after the gastric sleeve, Dr. Khaitan said. "But the bottom line is that we know reflux after gastric sleeve is a real entity and can be devastating for patients."
I found it interesting that bypass can also cause reflux, though it appears to be less frequent than with the sleeve.
The reasons for reflux are multifactorial. What we need is to develop an algorithm for studying patients that are having weight loss surgery and do randomized trials [from which] we can better understand if a patient gets better or worse after a gastric bypass or sleeve gastrectomy.
They suggest all WLS candidates get an endoscopy to help guide which procedure is best, and careful testing and diagnosis of reflux post-op to determine the best solution which is not always conversion to bypass.
Hiatal hernias and issues with the lower esophogeal sphincter can be corrected without conversion to bypass, for example.
In my case, reflux was resolved by the weight loss post-VSG, and bypass was not a good option for me for other health concerns.
So it's really good to see that they're looking into the different causes of reflux and advising to tailor the treatment to the root cause.
Great article! The higher risk of GERD post-VSG was my main concern, but after my endoscopy and discussing it with my surgeon, he confirmed that he thought the VSG was the best fit for me. Great to see more studies looking into that specific issue!
VSG on 1/2/2018!
Age: 27 Height: 5'8"
HW: 354 (May 2017) SW: 319 (DOS, 1/2/2018) CW: 280 (3/6/2018)
Pre-Op: -35 M1: -24 M2: -13 M3: -???
My YouTube: Grace Gets Gastric
I had GERD prior to gastric bypass surgery and the Endoscopy I had a few weeks ago (8 months post-op) showed that my esophagitis has resolved. Yeah! I also stopped PPIs a few months ago and have not experienced any heartburn or other symptoms since then. For me, gastric bypass was the best surgery and has drastically reduced my risk for esophageal cancer per my GI surgeon.
Here are a couple more articles on the subject.....
http://www.obesityhelp.com/articles/gerd-and-the-linx-proced ure-after-bariatric-surgery http://www.obesityhelp.com/articles/wls-and-gastroesophageal-reflux-disease-gerd
HW:330 - GW:150 - MW:118-125
RW:190 - CW:130