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I've been seeing some posts about people who have had VSG and now have GERD. I had VSG almost 10 years ago and, while I have had some regain, I am still considered at a good BMI and not overweight. Problem is, I have really bad heartburn most days even with medication, and some days I have actual serious pain in my stomach. I have been tested and treated for an ulcer and have gone through more than 1 endoscopy.
I have seen that RNY surgery is usually done to correct GERD in VSG patients, but my concern is that I will lose too much weight if I get another surgery. I could afford to lose probably 20 pounds, but more than that and I would be very underweight.
Does anyone have any advice? I have seen some recent treatments for GERD such as the Links and fundoplication. Does anyone have experience with either of these?
Perfect! I will try to email/call my doctor today. (It would be nice to have an updated list of the do's and don'ts since information is ever changing). Thanks again for your insight!
It's been a while since I watched it but there's a video on YouTube of a woman bariatric surgeon who is giving a presentation to other bariatric surgeons regarding acid reflux after VSG She states the revision rate from sleeve to bypass due to reflux is 20%. That may not sound horrible but given the number of people who have wls, that adds up to a lot of people.
Treating them the same used to be the ASMBS recommendation, as that is what most surgeons did when they were first learning the sleeve. Their current recommendation is to follow your doctor's advice:
https://asmbs.org/patients/life-after-bariatric-surgery
Q: Which medications should I avoid after weight loss surgery?
A: Your surgeon or bariatric physician can offer guidance on this topic. One clear class of medications to avoid after Roux-en-Y gastric bypass is the "Non-steroidal anti-inflammatory drugs" (NSAIDs), which can cause ulcers or stomach irritation in anyone but are especially linked to a kind of ulcer called "marginal ulcer" after gastric bypass. Marginal ulcers can bleed or perforate. Usually they are not fatal, but they can cause a lot of months or years of misery, and are a common cause of re-operation, and even (rarely) reversal of gastric bypass.
Some surgeons advise limiting the use of NSAIDs after sleeve gastrectomy and adjustable gastric banding as well. Corticosteroids (such as prednisone) can also cause ulcers and poor healing but may be necessary in some situations....
So, the advice basically remains the same as it always has been - check with your doctor, particularly since he recommended this course of treatment in the first place soon after your surgery; he knows you better and implicitly (by his original advice) has more experience than most when it comes to the VSG. Even if you aren't local anymore, perhaps you can drop him an email about this (my surgeon isn't local, either, but it still gets a response - even a phone response if that is appropriate). Another possibility would be to look up Dr. Alvarez (he posts here occasionally) who specializes in the VSG and is big on social media and does some Q and A things. He may be better than a random bariatric surgeon who are often primarily bypass guys who do VSGs on the side.
1st support group/seminar - 8/03 (has it been that long?)
Wife's DS - 5/05 w Dr. Robert Rabkin VSG on 5/9/11 by Dr. John Rabkin
Thank you Grim! Do you have a recommendation of what to use instead? (I would call my doctor, but I now live in Florida and my Doctor is in Maryland and I haven't kept up with him in years).
In this case, there is no difference between the two. The ASMBS recommends no NSAIDS for both sleeve and RNY.
6'3" tall, male.
Highest weight was 475. RNY on 08/21/12. Current weight: 198.
M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.
Thank you! Yes, and there are differences between RNY limitations and sleeve. Gets jumbled together alot of times.
Check with your surgeon to see what he says, as the NSAID thing is an RNY specific limitation. While many surgeons cookie cutter things and treat all their patients the same irrespective the procedure they had - same supplements, dietary progression, medication limitations, etc. - there are also many who appreciate the differences and treat their patients accordingly.
There may also be something that works better for your particular case, so again, check with your surgeon, as he is responsible for your after care, even this far out.
1st support group/seminar - 8/03 (has it been that long?)
Wife's DS - 5/05 w Dr. Robert Rabkin VSG on 5/9/11 by Dr. John Rabkin
I read some BS online too about gerd and VSG ...it said that MOST people don't get severe acid reflux just mild heartburn in first few weeks after sleeve. It seems like A LOT more people have way worse than mild heartburn.
And thank you, I will keep you all updated. I emailed my doctor yesterday so hoping to hear back soon.
Please tell Me more about your fasting very invested in it
