Acid Reflux

I want to talk about acid reflux/heartburn and VSG.
Who had it before the surgery?
Did it go away or get more severe?
Who did not have a problem but did after their surgery?
Who takes medication for it? Does it work?
Any comments and experiences at all with
acid reflux/heartburn will help me. Thank you.

I had very mild acid reflux before VSG. As long as I took an acid reducer med every other day than I was fine. My surgeon felt ok doing the VSG since it was very mild. About 6 months post op it started to worsen. I was upped to two PPI a day, which worked for a bit but than I started getting esophagus swelling off and on from it. Now I'm also taking carafate 4 times a day which has helped, but there is still the possibility of revision to RNY if it continues to worsen.

Pre-surgery, I only got heartburn when I ate carbs or too soon before bed. After surgery (I'm in my 6th week post-op) I have heartburn most nights if I don't take a PPI that day. It's not painful, but I am constantly worried about gastric ulcers and esophageal damage as well as potential side effects of long-term PPI use like anemia, osteoporosis, and dementia. It's not awesome. I've noticed that coffee makes it much worse so I've cut that out for now. My surgeon typically prescribes 2 weeks of ranitidine and then wants patients to be on long term PPIs if they still have heartburn. I know other surgeons prescribe 3-6 months worth of PPIs post surgery and then expect that likely you won't have heartburn after that. So, I'm hoping that in another month or so the heartburn will be gone.

I never had it before surgery except during pregnancy. Since well I take protonix 2 x day and still wake up choking during the night. I have a f/u appointment with the bariatric clinic at the end of the month and I am going to talk to them about it

GERD tends to be a contraindication for VSG. Sometimes it's due to a hernia which can be fixed with VSG, but oftentimes VSG makes it worse requiring revision to RNY. Long term PPI use is risky.

If acid is a problem for you, please consider RNY instead.

So far, I am ok post VSG, though I had reflux prior to surgery and had been on a PPI for years. I did have a large hiatel hernia repaired at the time of WLS. However, I know I have to be vigilant in paying attention - I think keeping meals small and manageable may be important in avoiding it after VSG (just my opinion because it makes sense to me).

I'm awaiting an endoscopy to see if I have a haital hernia before making my decision on the sleeve. I'm totally on board for the sleeve except for my fear of reflux as I do have some now and don't want to take PPIs (so far I haven't had to). My scope is on June 8th and if they find I have one and it can be repaired during VSG surgery then I'll take the risk in the sleeve and hope for the best!

Why take a risk at all, when you can avoid it?

There are risks and cons with both options and many reasons I may prefer the sleeve. I have some medical issues that rely on anti inflammatory meds and though they may be remedied with weight loss over time, there's time between now and then...which is a long time - my surgery isn't for another 4+ months. My knee in particular could become an issue again in future even considering a significant loss making the sleeve a good option. My surgeon recommended a sleeve to be easier on my body in the event I want more children. I'd rather not have the malabsorption you get with RNY or take as much risk during the operation (shorter operating time and less invasive). That's all if I am a good candidate for the sleeve. I do like a lot of the benefits of having the sleeve over the RYN and believe I could do really well with this option. Also, since I have a lot to lose my surgeon mentioned that in the long term if I had the sleeve and didn't get as far in my weight loss as I would like that the RNY could be a next step. I'm not planning on that but with everything it's better to have options than not. Taking it one step at a time to decide and luckily I have a lot of time to consider all pros and cons of each.

NSAIDs are advised against with VSG just like RNY, so having VSG isn't going to let you use NSAIDs. (This is according to new, updated ASMBS recommendations. Old ones allowed for VSGers to use NSAIDs, but new research has changed those recommendations.)

Many people successfully have children after RNY.

VSG is not less invasive.

Planning for a revision tends to be a bad idea as revisions are riskier than initial surgery. Best to get the right surgery the first time.