Acid Reflux after Gastric Sleeve Surgery

How can you fix acid reflux after gastric sleeve surgery?

If you are planning to undergo bariatric surgery or have already had it, consider this: how often do you get heartburn? If you experience more frequent heartburn, you may have a problem called gastroesophageal reflux disease (GERD).

Just about everyone has heartburn sometimes. Heartburn is the most common symptom of GERD, but GERD is more serious than simple heartburn.

It occurs when instead of keeping food and acids in the stomach, a weak muscle lets them move back up (reflux) into the esophagus.

Not only does GERD feel uncomfortable or even painful, but it can also damage the esophagus – thus causing a problem called esophagitis.

GERD can affect different options and choices for bariatric surgery and may require treatment after bariatric surgery as well. Your doctor can discuss the best treatment options for you.

GERD and Weight

People with excess weight or obesity are much more likely to have GERD. Reflux also happens more frequently as Body-Mass-Index (BMI) increases.

Most overweight individuals complain of heartburn. Excess fat accumulation inside the belly contributes to increased pressure on the stomach, leading to acid reflux. Overeating stretches and weakens the lower esophageal sphincter, LES, allowing acid to reflux back up into the esophagus.

Delayed gastric emptying and a dilated gastric fundus (upper part of the stomach) also may contribute to the increased incidence of heartburn in this patient population.

Most doctors advise weight loss and/or weight management as one way to improve GERD symptoms. For people with obesity (BMI>30), weight loss is critical to the success of treatment.

What causes acid reflux after gastric sleeve surgery?

The stomach, in its regular form, is a pressurized tube. On the upper end of the stomach is the lower esophageal sphincter or LES, preventing acid from moving up into the esophagus, while on the lower end the pyloric valve regulates how food and drink enter the small intestine.

Unlike during the gastric bypass, which cuts away the pyloric valve and depressurizes the stomach, the gastric sleeve leaves the pyloric valve intact and the stomach significantly smaller.

Therefore, the pressure within the stomach is increased, and the lower esophageal sphincter is the path of least resistance for excess pressure to dissipate.

When the pressure is released into the esophagus, stomach acid often accompanies it, causing reflux.

Fixing acid reflux after gastric sleeve surgery

Although bariatric surgery can alleviate GERD, it is possible to have GERD after surgery. If you have had bariatric surgery and you still have GERD, tell your surgeon.

It may affect your quality of life and keep you from reaping the full benefits of weight loss. If you must eat to settle your stomach, GERD can even make it more difficult to comply with your diet.

Your doctor can help you find the cause of your GERD and recommend treatment for it.

Here are some treatment options available to help alleviate GERD after gastric sleeve surgery:

1. Dietary habits – Reduce or avoid common acid reflux trigger foods. These include alcohol, tomato products, chocolate, coffee, spicy food, carbonated drinks, peppermint, greasy foods, and fatty foods.
2. Medication – Antacids neutralize stomach acid. Ask your doctor which antacids are appropriate for you.
3. Endoscopic GERD treatment – Stretta, non-surgical outpatient treatment for GERD, fortifies the sphincter between the esophagus and the stomach to improve the barrier and prevent reflux.
4. Surgery – GERD after any bariatric surgery may indicate that there is a hiatal hernia that may require surgical repair. GERD after sleeve gastrectomy may also be caused by a twisted sleeve which may also need surgical repair.
   Individuals with severe GERD after sleeve gastrectomy will occasionally need a second bariatric surgery, converting the sleeve to a gastric bypass.

Multidisciplinary team approach to GERD care at KLASS

Acid reflux, heartburn, and GERD can happen to anyone after bariatric surgery. It’s uncomfortable, frustrating, and can cause issues down the road.
With the right bariatric surgery or additional treatment, you can find relief from the discomfort of GERD and prevent damage to your esophagus.
If you have persistent heartburn after sleeve surgery, Kenya Laparoscopic Surgery Services (KLASS) offers thorough evaluation for bariatric patients.
Our acid reflux and bariatric surgery expert in Kenya, Dr. Yusuf Palkhi, has adopted a comprehensive approach for sleeve patients suffering from acid reflux.
Dr. Yusuf Palkhi offers advanced solutions to help you get rid of acid reflux and enjoy weight loss. If you are a gastric sleeve patient and suffer from acid reflux, please contact us today.