OT: PPI's (like prilosec)

You can wean off of them, if your body is willing, as stopping cold turkey usually just results in rebound reflux. Substituting part of the dose with another class of drug such as Zantac (ranitidine) or Pepcid is one of the normal procedures for doing so, or at least dialing back the dosage if total elimination isn't possible.

It is definitely worth getting yourself scoped with your history, and considering the possible, though rare, possibilities, sooner is better than later. A year ago this month when I went in for the routine colonoscopy, the gastro "upsold" me on also getting an EGD as well as long as I was on the table and knocked out (a 2-for-1 sale!) considering my history being somewhat similar to yours, though maybe not quite as acute. Yep - he found a cancerous polyp within a small hiatal hernia, and with all of the ramifications that Laura outlined above. It was a stage 1 and all was cleared out endoscopically, but considering the structure of the stomach wall, it was within a mm or two of getting into the third (of five) layer where the lymph nodes and most of the blood supply is. So, a year or less later it would have been into a stage 2 or above where they would have been having to chase it down with a lot more of their unpleasantries and with less overall success rather than having stopped it early.

So, go ahead and get the scoping done.

Note that this is not to be alarmist or to dissuade others from getting a VSG or any other WLS. This is an exceptionally rare cir****tance and it is difficult to pin down all of the contributing factors. The only other case that I have found referenced in OH is from a post op bypass patient several years ago - so choice of procedure is not specifically protective or preventative, but rather may simply allow for other vectors to exist (and a bypass can make if more difficult to detect early). Also, considering that obesity is a risk factor in many cancers, including gastroesophagael ones, it's difficult to say whether one is at greater of lesser risk by having WLS. You make your choices and take your chances in life.

Excellent, very helpful post. Thank you!

I will reiterate what others have said. I ignored my reflux and finally went in for a scope. They found I had Barrett's esophagus, which are pre-cancerous cells, just waiting around to turn into cancer. I chose to have the cells ablated, which was done 3 times. Now, I get scoped once a year. The danger for VSGers is that if you develop esophageal cancer, they must remove that part of your esophagus and pull op your stomach to make it part of your new esophagus. Since VSG surgery removes most of your stomach, there will not be any stomach they can pull up.

So, it is imperative that people with reflux get scoped to make sure that there are not any abnormal cells, and if there are, they are treated immediately.

I agree with all who said have the test. I had to revise from VSG to RNY because of GERD that developed after my surgery. But for the scope I would not have known of the lesions on my esophagus or the fact that I was having micro aspirations of acid into my lungs. In my opinion, while Prilosec, nexium, etc are sold OTC, they are typically prescribed for short course use (2 weeks at a time). You've been taking it daily for how long?? I would be concerned about the long term consequences of the medication to my kidneys, etc. For me, PPIs didn't offer any relief (other than Dexilant, but that's another story). However, if they did, I would have had to think long and hard about the risks associated with long term use (kidney issues, potential correlation with Alzheimers/dementia, etc.) v. the benefits (controlled acid).

Anyway, that's a very round about way of saying don't nickel and dime your health. Have the scope.

Hi Stacy, I am scheduled April 10 - VSG and have been reading a lot. I had the test for GERD and an fine, I only have problems if I eat late, a lot and go to bed. The Dr. Doesn't seem to be worried, but after reading these posts on this thread... how nervous should I be about GERD - Acid Reflux. One gal talked about if the esophagus is taken out the stomach is used with VSG there is not enough to pull up. Yikes! I realize a lot of excess weight is a ticking time bomb and I want to avoid issues in the future. How nervous should I be and do you recommend certain check ups to make sure things are ok? I have two teenagers and want to live a long time! Thanks!

I can't really answer that question. I had no issues with GERD prior to my VSG. It developed 8 months after surgery. What test for GERD did you have? An endoscopy? The VSG is a high pressure, closed system, and as a result, the acid (if you're unlucky enough to develop extra acid) has nowhere to go but up back into the esophagus. It's such an individual decision, but knowing what I know now, if I had GERD prior to surgery, I never would have picked VSG (and in fact, my surgeon would not have done the surgery. He told me if I had GERD previously and insisted on VSG, he would have told me to find another surgeon) I think if you're really concerned and think it might be a problem for you in the future, you bring up your concerns to your surgeon and get his/her opinion on RNY. Good luck!!

I had the endoscopy and showed no signs of GERD. I am sorry you have had to deal with it. I understand it is a small percent, with surgeries comes possible side effects and I am probably over analyzing everything. Informed of course is important. Thank you.

Hi BB, well I had reflux a lot before vsg but hiatal hernia was fixed during that. Needed PPIs for a while but now don't . However, DH developed hiatal hernia after VSG. Dr. said he was seeing more of this and thinks gut fat kind of holds everything in place and when gut fat is gone, the hernia reveals itself. DH still takes a PPI and sleeps with head elevated. Prilosec is way cheaper at costco.

Yeah I would bite the bullit and have the test. Better safe than sorry. GL. Diane S

Interesting comment / theory by your doc. Thanks, Diane.

Thank you for posting this, and for all the responses it has been helpful for me.

I had surgery 6 months ago and the first few months were hideous gerd/reflux. Got it under control with PPI and careful diet management and was good for a couple months. Then out of the blue it kicked off again (although to be fair I had been very stressed with the sudden death of my brother this year).

My surgeon would like me to do a barium test but I see that mostly people have discussed having an endoscopy.

My queston is what are the differences (pro's & cons) of each and suggestions about how I move forward. I live in a country where my insurance will not cover it because it was elective surgery so the cost to me will be around up to $2k and I want to get the right thing.

Thank you.