While bariatric surgery produces life-changing weight loss for most patients, some individuals experience new or worsening heartburn and gastroesophageal reflux symptoms after their procedure. Understanding why this occurs and what can be done about it is an important part of the post-operative journey.
Why Reflux Can Develop After Surgery
Acid reflux after weight loss surgery is most commonly associated with the sleeve gastrectomy. The sleeve procedure changes the shape and pressure dynamics of the stomach, which can weaken the lower esophageal sphincter and increase acid exposure in the esophagus. Studies suggest that up to 20 to 30 percent of sleeve gastrectomy patients may develop new reflux symptoms after surgery.
Gastric bypass, on the other hand, tends to improve or resolve pre-existing reflux because it reroutes the digestive tract away from the primary acid-producing portion of the stomach. For this reason, gastric bypass is often the recommended procedure for patients with significant pre-existing GERD.
Treatment Options
Mild post-operative reflux can often be managed with lifestyle modifications such as avoiding trigger foods, eating smaller meals, not lying down after eating, and elevating the head of the bed. Proton pump inhibitors and other acid-reducing medications may also provide relief. For patients with severe or persistent reflux that does not respond to conservative treatment, surgical revision may be recommended. Converting a sleeve gastrectomy to a gastric bypass is the most common revision for refractory reflux.
If you are experiencing heartburn or reflux after weight loss surgery, the team at MISH Hospital in Lenexa, Kansas can evaluate your symptoms and recommend the most appropriate treatment. Contact us at (913) 322-7408.