Revision from Sleeve to Bypass?

Hi, I've had sleeve since 2011 but am having loads of heartburn and reflux and annoying belching.

i will be having an EGD next week and my surgeon said depending on the results I may be eligible to revise to bypass.

Would this be a wise decision? My BMI is 30. Would it help me lose more weight? What are pros/cons to revising and what will be biggest change for me in going from Sleeve to bypass?

I would be so appreciative of any info you can provide!

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Revisions from sleeve to bypass for reflux are really common. Your alternatives are living with debilitating discomfort, and possibly a deadly cancer, or horrible, horrible side effects from long term PPI use. So yeah, its a wise decision.

It could help you lose weight, certainly. But it will take work on your part.

There is very little difference in lifestyle between the two surgeries. We are supposed to be eating the same diets. If you eat too much sugar or simple carbs, you might feel like crap with a bypass. But most don't, unless they eat a lot.

Both surgeries are supposed to be on vitamins. You might need more with a bypass than sleeve, but it's not a big deal if you keep up with it. A few more vitamins are preferable to acid meds.

Thank you so much!

Most of us don't have to do PPIs. I was off them for almost a year and started having severe stomach pain. Carafate fixed that so my surgeon's office felt the pain I experienced was the result of the beginnings of an ulcer. I never could understand why. I'm nice to Tiny P, I abuse Tiny P not at all. I feed Tiny P good food, I don't smoke, don't eat spicy foods, etc and Tiny P got feisty. So now I take omeprazole to prevent ulcers. Go figure. If I don't take it for a while, I'm fine and might be fine if I stopped taking it but that pain was BAAAD. I have an appt soon for a follow up (mine follows every 6 months forever) and I'm going to ask about the omeprazole. I just never want that pain again but I don't know about the long term use of PPIs either.

I love how you call it your "Tiny P" and refer to it like an individual

LOL, Tiny P quite often has a mind of its own.

I had severe GERD pre-surgery and have none now. My best advice is there is another community here on obesity helps where they are all revision patients and you would probably find many who have gone from sleeve to bypass due to GERD and give you a much more personal information on what it is like to go from sleeve to bypass. I know that revision surgery has some weight loss benefits but it is a much slower rate of weight loss. I've heard that constipation is worse with bypass and is one of my major struggles. With a sleeve, the sphincter at the bottom of the stomach is preserved but not with a bypass. I'm not sure whether that means food will go through the stomach faster than a sleeve but I think that is true. Because of the malabsorptive portion of the bypass, it will be critical that you take certain vitamins to prevent significant nutrient deficiencies and that you cannot be lackadaisical about taking them. I have alarms on my phone so that I don't forget. I think in 18 months, I may have missed taking my vitamins 2 or 3 times.

As I said, I'd go check out the forum with revision patients. They will be a lot more knowledgeable probably than those of us who have had the single surgery. What I know is from being involved in different social media and what these friends have said and the research I did regarding both surgeries. That's not to say there aren't WLS patients that had RNY after sleeve here on this forum though so definitely wait for answers.

Thank you for your reply! I did also post in the Revisions forum but surprisingly have received more responses from this board. Thanks again!

Hi. I am a VSG to RNY conversion. My reflux, which was non-existent before my surgery, was off the charts with a DeMeester score of almost 90. I couldn't sleep without regurgitating acid. The conversion to RNY helped, but unlike most, it did not cure my acid. I'm still on a PPI. I have an additional issue in that the only PPI that works for me is Dexilant (I have a gene mutation that affects the rate I metabolize omeprazole and other PPIs. Dexilant utilizes another channel through the liver and is uneffected. If you find that omeprazole doesn't provide you with relief, you may want to be tested. It's a simple blood test)

I was about 10 lbs from goal (I was at goal, but due to the fact that the only food that neutralized the acid was crackers, I gained a few lbs prior to my surgery). my regain and the last few pounds came off relatively quickly, but my surgeon did warn me that weight loss was slower after a conversion than with a virgin surgery.

As far as vitamins, my surgeon does not differentiate between surgeries when he advised regarding vitamin intake. So, VSG patients take the same as RNY patients. Therefore, there was no change for me.

Since I've been through it, I'm happy to answer any questions you may have