Gerd and VSG

WOW! That sounds like great news... I know all results are not the same, but same goes with the risk of each wls, and that's why I prefer the VSG. It just seems less invasive and dangerous. The risk of long term complications is what I'm so afraid of with the RNY, and rerouting my intestines just doesn't sit well with me.

Why are you afraid of RNY?

The list of complication risk scare me. I know there risk with all wls, but the rerouting of intestines and long term risk of the RNY bother me.

I don't have the long-term data at hand, but having part of your stomach permanently removed is just about as risky.

GERD/reflux is nothing to fool around with.  Yes, you may have a hiatal hernia, and fixing that might take care of the reflux.  Weight loss by itself might make the reflux go away.  But a sleeve creates a high pressure system that tends to make GERD worse.  Basically, it's Russian roulette when you have pre-existing reflux and you get the sleeve.

I had very minor GERD issues prior to VSG. My GERD was really diet dependent and the more weight I lost the better it got. However, about a year post op I did start having issues with acid production. I didn't have reflux, but I did have a really grumbly stomach and terrible hunger about half an hour after eating. Those symptoms caused my bariatric MD to put me on a PPI. I've been on the PPI for quite some time and now when I don't take it I get reflux. So, it's a bit of a catch 22. 

IF you have pre-existing GERD and are already on meds for it, I'd think long and hard about pursuing a VSG. For most the VSG seems to exacerbate the symptoms of GERD to the point where meds are no longer effective. Revision is the only option. 

I get not wanting to have your intestines rerouted, but RNY might be the very best option for you. 

I had an identical situation. Prior to my sleeve I had horrible reflux and the surgeon recommended Rny. I had concerns about the Rny as well, particularly given my history of forgetting meds and by default vitamin supplements. My surgeon did find a hiatel herna during the sleeve and fixed it. I woke up completely free from acid for the first time in years. Fast forward 4 years, and the reflux was back with a vengence. Turns out that most of my stomach was up in the chest area (huge hiatel herna again) and I was unable to keep food down. Now, perhaps the sleeve caused this- but perhaps not. Had I only had the hernia fixed I could have been in the same boat in other words.He was able to repair it a second time, but should occur again his only recourse would be to switch to Rny. 

There are a lot of us on the boards that found complete or huge improvement post sleeve due to the hiatel hernia repair. As Grim mentioned, there are also many who had no reflux or worsened post sleeve. There is no way of knowing which camp you will fall into until after the procuedure is done. 

Back when I was making the decision, I decided that if he wouldn't do sleeve I wouldn't do Rny. In hindsight, that would have been a mistake. I still prefer my sleeve for sure, but knowing what I know now if the Rny was the only choice given I would not hesitate to have the Rny done. As Grim mentioned, compliance is a choice and if you comply risks decrease accordingly. There is a little less risk with the sleeve surgically speaking, but the risk level for both surgeries are very very low- comparable to gallbladder surgery. 

Pre-op, I had a large hiatal hernia and severe acid reflux. My surgeon would have done RNY instead of the sleeve except for the fact that at the time of my initial pre-op consult, I was taking prednisone. Prednisone and RNY do not do well together.

One and a half years post-op (band-to-sleeve revision; hernia repaired) and 20 pounds shy of my goal weight, I still need one omeprazole capsule a day or I get reflux. Still, I've had a tremendous decrease in acid reflux and at one point was off omeprazole altogether. 

I do believe, however, that my case is the exception rather than the rule.

psychoticparrot

I am 8 years post op with the VSG and I have been on Nexium pretty much since surgery with no problems until a few months ago.  I started having problems with UTI's and was on antibiotics.  After having a procedure done in December 2015 I developed a severe infection that was resistant to oral antibiotics resulting in having to have a PICC line and IV antibiotics.  I was also on long term course of macrobid and developed a ton of rare side effects from that are still causing me problems.   During this time I started having more problems with Reflux that worsened even more when my Dr put me on a supplement.  

I just had a Barium Swallow that shows a large Hiatal Hernia and that part of my stomach is above my diaphragm and a lot of reflux.  I haven't seen the Dr yet, just the test results so I don't know what it is going to mean until Thurs.  

Still I would not have changed having the VGS for anything.  I can't say that this is a complication of the surgery, at least not yet.  In my research I have read that sometimes in repairing this type of hernia with a normal stomach they stitch the stomach so that it can't slide through if the hernia returns so that may be an option to ask about prior to VGS if you already have a hiatal hernia

I am really starting to wonder now if large hiatel hernias might be a risk of the sleeve. This occurred to me as well, and I keep seeing posts of others in the same boat. Not a huge number, but enough that there is a pattern. Hmmmm. Wondering if this is going to eventually result in some of us revising to Rny to take care of the high pressure problem. Hope not.