Gastro-oesophageal reflux disease (also known as GERD or GORD) is a recognised side effect of gastric sleeve surgery.
In recent years there has been much debate about this, and some have argued the opposite, but there is now a consensus that sleeve patients are at increased risk of experiencing the symptoms of heartburn and gastristis associated with acid reflux.
What is Acid Reflux
Reflux occurs when stomach contents are forced up into the oesophagus (gullet). This can cause various symptoms including, but not limited to soreness, heartburn and pain. These symptoms are caused by stomach acid refluxing up into the oesoaphagud. Often symptoms are worse at night or when you are laying flat. It is important to have these symptoms investigated and treated as persistent reflux over a long period of time can cause permanent damage.
Acid Reflux and the Gastric Sleeve
Sleeve patients are at increased risk of reflux because the sleeve both reduces the size of the stomach and increases the pressure inside. This increased pressure causes stomach content to reflux.
We reduce this risk by screening out patients who have a history of reflux. This is not uncommon as obesity is also linked to an increased incidence of reflux. For patients with pre-operative reflux, we generally recommend gastric bypass (Roux en Y) or gastric band surgery. The bypass is especially effective in treating reflux with over 90% of patients seeing a complete resolution of their symptoms.
If you've had sleeve surgery and you are experiencing reflux, the first course of treatment is usually medical therapy using a Proton Pump Inhibitor (PPI). PPIS are very effective and millions of people in the UK use them on a regular basis. They are both safe and effective. Over time, however, this effectiveness can diminish and further surgery may be considered. The two surgical options are the revision of the sleeve to a gastric bypass or LINX anti-reflux surgery.
As we have referred to above, the bypass is extremely effective for patients with reflux. However, in order to be eligible patients will generally need a BMI above 35.
LINX Reflux Surgery
If your BMI is below 35 we might consider LINX reflux surgery. The LINX is a device that is placed around the oesophagus to help it function normally. the device comprises a number of magnetised beads that open when you swallow to allow food into the stomach but that keep the lower oesophageal sphincter (LOS) closed at other times to prevent stomach contents flowing up. the LINX is an effective treatment for reflux in over 80% of patients. Fundoplication surgery, an alternative surgical reflux treatment, is not available to sleeve patients due to the reduced size of the stomach after sleeve.
So, if you suffer from the symptoms of reflux it is important to discuss this with us before you proceed with weight loss surgery as it will affect the type of surgery that is recommended.
If after sleeve surgery, you experience reflux symptoms let us know as soon as possible so we can assess the reasons and advise on the best course of treatment. We are specialists in the gastric sleeve and have considerable experience in the treatment of reflux.
Gastric sleeve centre