GASTRIC SLEEVE CONVERTED TO A GASTRIC BYPASS.. HELP!!

Well its been a minute since I posted on this site, but that say you always come back to your roots when things get tough. I was sleeved on 03/15/2011 lost 115 lbs and have been happy with the surgery and my results, however in the past year or so I started having problems with when I eat I would have this sharp pain between my breast bone when I swallow and it also caused me to start having really bad pain GERD and Acid Reflux.  I was diagnosis with a hiatal hernia, and my doctor felt it was necessary to do a hiatal hernia repair surgery. It seem to resolve the problem I though I was back on trac****il one day which was about 2 months after the hernia surgery I started feeling the pain again, I thought I had a hernia again and the Acid Reflux came back. After numerous exams and GI imaging, my doctor told me that he didn't think that the hernia was back but in a few rare cases this happens and when it does and you continue to have problems with the pain and Acid reflux he suggested that my sleeve be converted to a gastric bypass!! Of course Im terrified and scared and dont know what to do. Currently he prescribed some meds thats helping give me relief however I dont think this is a long term solution. Has anyone been converted to a bypass or know of anyone.. I really dont want to undergo another surgery but want to be healthy and make the right decision... Thanks

there are worse things than RNY. .like esophagus cancer due to gerd, lung disease due to acid aspiration into the lungs...etc etc..  

Not that you should get anyone of them.  But worry about what iff - ?? 

A lot of people live with GERD.  Taking PPI, diet, timing of your meals..  head elevation during sleeping... 

plus some people report using apple cider vinegar...google that... and try your best to avoid ANY surgery... stress - may cause GERD.. 

I had RNY - when I stress- it burns.. I use PPI... yea.. have to. 

Hi Diva - what you're going through sounds awful.  I have reflux that I've finally been able to control with Protonix but if that had failed I would have considered revision to bypass.  Why?  Because the very real risk of severe ulcers and esophageal cancer are a whole lot scarier 

I have a good friend who had VSG 3 years ago.  In the last year she developed horrible acid reflux and GERD.  She converted to bypass and is very happy with the results.  

I would suggest as everyone else has - consider revision surgery a last option.  Try everything else first including the lifestyle changes.  Try different meds, etc.  But if all else fails, do the surgery.  Like someone else said, there are worse things that having gastric bypass! 

The VSG can be a very high pressure system.

This surgery is far more complex than most people think and are led to believe.

To really diagnose gerd many things need to be looked at, as the entire intake track from mouth to pyloric valve needs to be studied.

Not saying this is you, but a major cause of a hiatal hernia and gerd is over eating. The pyloric valve closes and food starts going up and than pressure builds and pushes up on and through your esophagus.

Another major cause of gerd is a mis-shaped sleeve...... in basics it really needs to be banana shaped (rough example). A common mistake is a sleeve shaped like an hour glass (rough example). To big at the top of the sleeve or one that is tighter in the middle will promote food/acids to get pushed up.

Aggressive treatment of a hiatal hernia and a proper shaped sleeve all to promote directional food flow "helps" greatly in controlling gerd.

The other thing most VSGers don't know is the esophagus "can" expand to a larger diameter than your sleeve.

Converting to RNY would be a logical step after other things have been studied.

**** Get medical guidance from your doctor.

Hope this helps...

frisco

I wasn't converted, but GERD was the reason I chose RNY over VSG. I already had severe GERD that didn't get any better with the 80 lbs I lost pre-op. I had intestinal metaplasia and the beginnings of Barrett's esophagus by age 27, and even on twice daily Prilosec, I had horrible pangs of nausea that would lead me to sneeze all the time (due to the acid irritating the vagus nerve). When I met my surgeon, he said he would do either on me, but let me know a revision to RNY might be a real possibility if my GERD got any worse with VSG. I opted to cut out the middle man, but if I were to have had the VSG and only developed (or noticed) GERD after it, I would have been upset but resigned...no one wants another surgery, but getting some relief and lowering your risk of esophageal cancer would be worth it in my opinion. I'm still on twice daily Pepcid prophylactically, but I have none of the GERD symptoms I had before my RNY. 

I'm in the same boat. I've had the GI imaging, have a small hernia. I've tried all the acid reflux medications. I know Nexium in the long run can cause kidney damage I've seen it on tv. I'm on carafate and the reflux continues after 3 hours I have tried all the medications. I should've had the gastric bypass since I've had acid reflux prior to my surgery. My surgeon wants to do a revision and I'm also scared and concerned. I do wonder if one looses any weight with the revision? I was sleeved on 6/13/13.

I am in the exact same situation. Over Christmas of 2016 I had my gallbladder removed and a very large hiatel hernia repaired. During the vsg surgery I had a hiatel hernia repaired, so there is no third time for me. My surgeon also indicated that I will revise to bypass should further severe symptoms continue. I was doing very well for a while, but starting to be mildly symptomatic again. If gerd resumes without relief via prescriptions then I will revise. I am hoping to avoid that.

Ok, so this is a worry for me. I had a EGD in December to evaluate as to if I needed a revision. My hernia was confirmed and some early Barrett's was seen. My surgeon said my sleeve was good. I think I will see my GI again to see if a revision to mini rny might be necessary for my long-term health..