Question on VSG and GERD

I have been researching this procedure for a long time. I am aware GERD can worsen after the sleeve. I spoke to my surgeon about this and he said this can be controlled with medication, which I am fine with. I have been on Nexium for many, many years. 

Recently in my research I read it is possible GERD after VSG could not be controlled with medication and therefore the only option is to revise to bypass surgery. 

My question is has anyone experienced this or know someone who has? Or can you provide any information on how likely this is to happen? I do not want bypass surgery, it scares me! 

Bypass surgery is more work for the surgeon and he might prefer to do the easier operation.  With GERD I would never consider a sleeve.  The bypass normally cures the GERD. 

The bypass is nothing to be afraid of.  The diet is the same after both surgeries but with the bypass it is easier to lose weight because all of the food you eat is not being absorbed.

Get the right surgery the first time.

Have you been checked for hernias?  Sometimes a hernia can be the cause of GERD which can then be resolved during surgery. 

Hi Gwen

I forgot to include it in my post but YES I do have a hiatial hernia. I knew I had it before my endoscopy last month because I had a scope in 1999. When the scope was done last month, he characterized the hernia as small.  I don't know if a "small" hernia would cause all of the heartburn I've had for the last zillion years or not. I will be calling my surgeons office. 

I know two people in my local support group that had horrible gerd with the sleeve. Both converted to RNY, both had gerd disappear, and they couldn't be happier. 

I wouldn't want to be o a PPI for life. One of my goals for surgery was to get off all medication, and I have. Obviously, you have a tough decision. But if I had gerd, I wouldn't do VSG.

I must be the exception to the rule because I had GERD for decades prior to getting my sleeve, and took Nexium everyday.  I'm 8 weeks post op and I'm completely off Nexium and no GERD whatsoever!  But for the most part, I also don't eat after 6:00PM.  I talked to my surgeon about my concerns, especially since I ended up with Barrett's esophagus because of GERD, but due to the fact I only have one kidney, we decided together that the sleeve would be better for me because it allows more liquid intake...I used to drink 3/4 of a gallon of water a day pre surgery (working my way back to that).

Talk to your surgeon and discuss your GERD concerns with them. Your body is different than everybody elses body and your doctor will help you decide what is best for you and your body.

Much luck to you!

I don't know why VSG would allow more fluid intake than RNY. I don't know anyone beyond the first couple of months, with either surgery, that have trouble drinking. I get in between 180 and 200 ounces a day, without trying.

I planned on VSG for 3 years until my surgeon said it would be a bad fit with my GERD. He said he would do it if I wanted, but that there would be a good chance I'd need to revise to RNY later anyway. I couldn't be happier now I followed his advice. I've gone from twice-daily Prilosec still with frequent GERD-related nausea spells to taking it once daily with zero symptoms at all.

I was so scared of RNY that I lost 80 lbs pre-op just to reduce my risk as much as possible. My husband had VSG two weeks after my RNY, and our recoveries have been almost identical. The only differences are that I get some reactive hypoglycemia if I eat sugar in isolation (which I deal with by avoiding this), and he developed some GERD post-VSG while mine improved substantially post-RNY.

Reflux "can" also have a lot to do with surgical technique.....

The VSG is a NON Standardized procedure and goes way beyond a partial gastrectomy.

It's a system that should be studied and designed from the throat to the pyloric valve to promote directional food flow.

frisco

I never had GERD before my VSG.  Ever.  In fact, sometimes I think I'm the only fat person that never had it!  Kidding aside, after my VSG I have had terrible GERD.  I religiously take Dexilant which worked up until a few weeks ago (I'm on the cusp of six months since surgery).  Now I am experiencing sudden horrid reflux. I see the surgeon Monday to address it and see what options are.  I do have a (very small) hiatal hernia that appeared after surgery which we saw on a leak test after.  We'll see what he says tomorrow. Even despite this, I'd do the surgery again in a heartbeat.  I will revise if I must, but hopefully I can avoid it.