GERD-does it get better after RNY? Conflicting advice from 2 doctors-so confused

Well, I had the sleeve for 2 wonderful years.  Was troubled with GERD before the sleeve.  The first 2 years were o.k. as far as the acid as long as I made SURE to take the PPI daily.  Then, I had severe episode of vomiting, developed hiatal hernia and such severe acid reflux that lab proved toxic doses of PPI's, antacids, etc would not touch.  I had erosions from the back of my throat down into my intestines.  After seeing 3 different WLS surgeons and they ALL said that the RNY would be the only thing that would help me, I revised to the RNY.  All 3 did tell me that i still had 5% chance of reflux after surgery. 

 

Knock on wood, but I have had no reflux after surgery.  It has only been 4 months however and I am still on post op PPI which they want me on for several months after surgery.

 

You made a statement that the GI Dr said it would be easier for her to do her exams because of the anatomy after the surgery.  It isn't about how easy the procedure will be for her.  It is about what will be best for you.   Have your surgeon refer you to someone who is use to and capable of taking care of a patient after RNY. 

 

Best of luck on your decision.

Good point. So I guess from the GI doc's perspective-GERD in sleeve patients is much easier for her to deal with than an RNY patient. But I suppose she doesn't realize how many RNY patients have been CURED of it. She only sees those still afflicted.

 

I have heard of people being revised to RNY after the sleeve for GERD. I would definitely like to avoid this.

"You made a statement that the GI Dr said it would be easier for her to do her exams because of the anatomy after the surgery. It isn't about how easy the procedure will be for her. It is about what will be best for you. Have your surgeon refer you to someone who is use to and capable of taking care of a patient after RNY."

I agree that it's not about whose life is made easier here, but I don't think that's what her GI Doc was referring to.  My surgeon told me that one of the advantages of the sleeve is that there is no "blind" stomach left behind.  The part that is not needed is removed.  With RNY, the part of your stomach that is not attached to your pouch is left behind and it continues to produce acid, but the only way to "check" on that part is through surgery.  It can no longer be visualized with an endoscopy. The way I understand it, the risk is that you can develop ulcers or even stomach cancer in your blind stomach, and it would impossible to do a scope on that without open surgery.

I had severe Reflux for years and was on daily medication for it. I had a EGD done by my surgeon before my surgery and he found a small hernia and would not recommend the sleeve for me. My insurance wouldn't cover the sleeve so this was ok with me. He did not repair the hernia as he said when he got in there the day of my surgery as it was very small and for some reason repairing it as such a small size was not his recommendation. This annoyed me at the time since I was charged $500 to find something that he didn't fix during surgery. I finally came to terms with it. I have not had any episodes of reflux since a month out of surgery. I have not had any of the medication for it as well, saving myself $30 a month.

That is wonderful! I am so hoping it cures my reflux, too!

 

Thank you for your post!

I'm still pre-op but when I saw my surgeon for the initial consult he asked which surgery I was considering. I said RNY and he asked if I would consider the sleeve. I told him I would if he thought it best, I just wanted which ever would be best for my Barrett's and GERD. He said, "You have Barrett's and GERD, there's no choice, RNY is the only one that will help you." He strongly recommended against the sleeve. He also said it would be absolutely necessary to repair the hiatal hernia while in there. This agrees with everything I had researched before and after the consult.

Best of luck to you.

Randy
 

Thank you for your post! This sounds like my surgeon! At first-he thought the sleeve would be best for me but now that he's seen my upper GI results--he doesn't even look at it as an option for me.

I had RNY, my surgeon would not consider sleeve because I had gerd. I still have it. Apparently there is a very small percentage of people that have an excess of acid producing receptors in their stomach. I'm one of those " lucky" few. I now take 80mg of Nexium everyday. I still have heartburn from time to time. If it were me making the decision for you... I would lean towards what your bariatric surgeon feels is the best option. You will be spending a lot more time dealing with the surgeon than you will with the GI doctor.
As far as NSAIDs go, I personally have not missed being able to take them. However, I don't have any on going health issues that might have made them an important part of my pain management ( thank you God! ). If you are currently leaning on NSAIDs for pain management you may want to ask if there are any non NSAID alternatives that might work for you. Good luck with whichever choice you make

I had terrible acid reflux.....BEFORE surgery. I was on Omeprazone every day and that took care of it 100%....I was lucky cause that sometimes doesn't work for others. I couldn't drink anything carbonated because it BURNED. Since surgery I have not had to take it at all....LOVE that it's gone! I did RNY. I had my Gallbladder removed because it was super bad (stuck to my liver) and I have a hiatel hernia & the surgeon stated it wouldn't come into play with RNY, so she never repaired it and no problems at all. Good luck on your decision (edcucation is the best thing you can do....so cudo's too you for reaching out to people who actually has had the surgeries;make sure you ask on the Sleeve site also). Good Luck.

i AM SO HAPPY YOU POSTED THIS ?, AND TO AL OF U HO REPLIED.  i INITIALLY WANTED THE SLEEVE, MY SURGEON, WHO HAS A REPUTATION OF BEING THE BEST IN OUR ARES,  did not recommend the sleeve, shes said she will do it ohn certain people who have scar aheshions, or one patient who was run over with a bus, I have been going from one forum (GS)  to (GB).  I have read many who had the sleeve complain about heart burn.  Have had GERB for 29 years, and have had many flare ups, the fear is for me I cannot afford to have these flare ups, they keep me up all night,  My gastro daughter told me in her opinion GB clears up some and other no.  But, to get worse by the sleeve scares the h out of me.  I wanted the sleeve  because in the end it seems from the forum talk, you can eat what you want, just smaller.  My Dr. Bariatric said you do ,not lose as much, but on the forum some do and others don't, I have researched and researched, read both forums now for months, but with my GERD which is so uncomfortable, now I am afraid of the sleeve.  Really don't want either, but will do the By pass, need to get healthier, and live longer, I ask myself what if I don't get it, don't want to go on like this, and may die younger, because of heart probles, GERD, sLEEP aPNEA,PRE DIABETIC, SO WHAT IS THE ALTERNATIVE, SO i CRY, BECAUSE i AM  SO SCARED, BUT  i CRY BECAUSE i WANT TO BE HERE FOR MY FAMILY AND GRANDBABIES, IT IS TIME, AND AFTER HEARNG THESE POST TODAY, AS i THANK U ALL, i AM GONG FOR THE GB, IF THE SLEEVE INCREASES GERD, I DON'T WANT IT, and when I went for clearenc to my heart DR, he told me the sleeve does not cure medical issues as the GB does.

Good luck, and after reading so many post I think we all are scared of such a  drastic change, but my bariatric Dr keeps telling me, if you do what you are told, let your stomach heal, there is no food you cannot eat.