Which is best with Reflux

on 3/24/14 1:10 am

I have been reading a lot about the sleeve since returning to OH and have a question for anyone who cares to answer.

I have an appointment to see the surgeon in April for revision from the lap band.  For the past several weeks, I have been set on the Vertical Sleeve.  But, in reading some posts today regarding GERD, I am now wondering about my choice.  I realize that my discussion with the surgeon will ultimately be the way the choice is made but, here is my question.

I am reading that RNY is the best way to go if you have GERD.  But I too have fears of re-routing my plumbing as much as is done with RNY.  What about the Duodenal Switch?  I have reflux from my pain meds and coffee.  The DS is a bit less re-routing and seems to be what a lot of VSG folks say will come down the road after VSG.  I really am curious what you have to say about it and there is nobody better to hear it from than the vets.

on 3/24/14 1:17 am

Do you know if you have a hiatal hernia? I'm scheduled for VSG and I have severe reflux. My surgeon acts like as long as the hernia is repaired and I stay on my omeprazole, I shouldn't have a problem. I hope he's correct..that is one issue that scares me too.

Brad Special

on 3/24/14 1:51 am
VSG on 12/06/12 with

I had reflux pretty bad and they did the sleeve and removed my gall bladder. I have not had reflux once since my surgery in December of 2012.

on 3/24/14 2:13 am

Okay, you've got some misinformation here. First off, the DS has the highest degree of re-routing---which is why it also has the highest degree of long-term, maintained weight loss. The RNY only bypasses a small per centage of your small intestine, and most folks' bodies are able to overcome the malabsorption of calories in about 18-24 months---but will always malabsorb certain vitamins and minerals. The DS also causes life-long malabsorption of certain vitamins and minerals, but with the DS you also malabsorb a significant per centage of calories always and forever. (And frankly, with a BMI of 61, you really should be seriously considering the DS.)

As for reflux---the RNY is generally considered the go-to surgery for that, but---prior to my DS, I had horrid reflux. Most nights I slept sitting up, it was so bad. My DS completely cured it. Keep in mind that I had my DS over ten years ago, and back then most surgeons made larger Sleeves than is the trend right now, especially for their DS patients. (The malabsorption of the DS balances out the ability to eat more food.) Back then, very few surgeons were doing stand-alone Sleeves, and almost no one talked about developing reflux after the DS---*I* think because of the larger Sleeves. As more and more stand-alone Sleeves were done, and regain reared its ugly head, surgeons started making Sleeves smaller and smaller---which has led to a dramatic increase in the number of people I see complaining about reflux after the Sleeve.

Yes, the DS is the logical revision if the Sleeve doesn't give you all the help you need, since the Sleeve is the stomach portion of the DS. But *if* you think you need malabsorption, why have two surgeries, with twice the surgical risk, and the very good chance that your insurance carrier won't cover the second surgery?

I couldn't be happier with my DS. The DS has the very best long-term stats for patients of ANY size, but especially so for those of us with a BMI greater than 50. It's also the best at resolving or preventing diabetes and high cholesterol. For the first time in my LIFE I'm pretty effortlessly maintaining my weight loss without feeling deprived and hungry. I eat a very normal 'diet' of about 3000 calories a day, but because of my DS I only absorb about half those calories.

on 3/24/14 3:52 am - Vancouver, WA

It does depend a great deal on what is causing the reflux. Like the OP mentioned if it is a hernia causing it, you may not have a problem with the sleeve. If something else is causing it then RNY might be a better choice. You really need to discuss it with your surgeon he will have a better idea which will be better for you. Best of luck to you!

Valerie G.
on 3/29/14 11:44 am - Northwest Mountains, GA

Boy do you have the DS backwards.  The DS has more intestinal re-routing, but yields higher results long term, and it's a logical revision from the VSG because they have the same sleeve stomach.  That being the case, the same problems with GERD exist with the DS as they do with VSG.  The RNY seems to have the fewest issues of GERD from what I've seen over the years.

DS 2005

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