Got GERD?

Oh! I thought you got it done this year, but yeah, a year out is probably pretty set. You said you didn't have acid before the VSG, but now that you've revised, how bad is it? It sounds like it's at least manageable, but it is to the point where you have to take anything for it? Or is it something you can avoid by not eating certain kinds of foods?

I'm definitely curious about how the revision works as far as clearing up GERD issues that develop as part of the VSG, since it doesn't seem all that uncommon for that to happen.

The reflux is about 90% better. I can manage it by taking a zantac, and I probably do that about 2-3x a week. It's really not triggered by any specific foods, so, for me, it's luck of the draw.

The mechanism is simple really. Because the VSG retains the pyloric valve, the VSG creates a closed high pressure system, and the acid has nowhere to go but up to your esophagus. For some people, their systems cannot handle the acid is such a small space, others adjust well. My system could not handle it. Also, some will say that repair of a hiatal hernia (to the extent there is one) will eliminate the acid. That was not true in my case as I had a hernia repair with my VSG and developed an acid issue in spite of the repair.

Converting to RNY solves the problem because it removes the pyloric valve and gravity allows the acid to flow down out of the stomach, minimizing the chance it will back up into the esophagus. In other words, you no longer have a closed high pressure system, but a system that open at both ends which allows the acid to flow downward through your system . . . or at least that's how it was explained to me.

That's a really great explanation! I'd read a bit about it, but you managed to summarize it really succinctly. Definitely a lot to think about!

Have there been any other adjustments or things you had to get used to when converting from the VSG to the RNY? Obviously the acid reduction is a great effect, but have you noticed in any significant differences, or did you need to make any adjustments with the change as well?

The only difference between my VSG and my RNY is that I now dump and have reactive hypoglycemia. Something that didn't happen with my VSG. I LOVED my VSG, I had the sleeve of steel and could eat anything (which doesn't mean that I did, I still stayed away from processed foods, sugars, etc. I maintained a high protein low carb diet and still do). So going from that to a body that dumps even on protein has been a bit of an adjustment. Other than that, I don't notice a difference.

I had very mild acid reflux prior to surgery. I was able to get away with only needing to take a PPI as needed. My upper GI was negative for reflux and my EGD was also negative. About 6 months after surgery I developed severe acid reflux so bad that it causes my esophagus to swell off and on. That feeling is the most uncomfortable feeling ever. Almost feels like you are choking or can't swallow properly. It's hard for me to lay flat at night now cause I will wake coughing from the acid sitting in my throat. My throat is also constantly sore and my voice is hoarse. Currently I am taking 2 PPI's a day and Carafate 4 times a day to coat my esophagus. I'm now 10 months out from surgery and still have to do this everyday. I may need revision to RNY in the future but for now they want to see if losing more weight will help lessen the acid. I've lost 140 pounds so far and would like to lose another 100. If you even have the slightest bit of reflux I would seriously consider RNY in my opinion. I love my sleeve, I just hate this constant swollen throats feeling.

Does your medical team have any theories on why the reflux came on so far out from surgery? How terrible that you have to deal with that!

They unfortunately do not. I have read where others developed it even a year out from surgery.

I have seen a lot of people develop gerd 3 or 4 years from VSG too.

Oh, gosh, that sounds rough! Yes, this is exactly the kind of thing I want to hear about. I do have very mild and very occasional acid, which makes me much more nervous than if I'd never experienced it at all. :/

I hope losing more weight lessons the acid for you!

I very rarely had acid reflux before surgery and had it fairly strongly as soon as I woke up from surgery. PPIs control it but I don't feel safe taking them. A week ago I started taking deglycerrized licorice (DGL) and so far it is controlling my acid really well. I still wake up in the morning with a slightly swollen esophagus every few days, but I'm less than 4 months post op and still hoping that the acid calms with time. Good luck on making the right choice for you!