Reflux after weight loss surgery

The following tips are to help relieve symptoms of reflux following a weight loss procedure. For more information and guidance, please call us and we can advise on your specific situation.

1. Eat sparingly and slowly

When the stomach is very full, there can be more reflux into the oesophagus. If it fits into your schedule, you may want to try what is sometimes called “grazing”—eating small meals more frequently rather than three large meals daily.

2. Avoid certain foods

There are still some foods that are more likely than others to trigger reflux, including mint, fatty foods, spicy foods, tomatoes, onions, garlic, coffee, tea, chocolate, and alcohol, caffeine, citrus juices. If you eat any of these foods regularly, you might try eliminating them to see if doing so controls your reflux, and then try adding them back one by one. As acid reflux tends to occur quite soon after eating the trigger food, it is usually easy to narrow down the exact cause of the symptoms.

3. Don’t drink carbonated beverages

They make you burp, which sends acid into the oesophagus. Drink flat water instead of sparkling water.

4. Stay up after eating

When you’re standing, or even sitting, gravity alone helps keeps acid in the stomach, where it belongs. Finish eating three hours before you go to bed. This means no naps after lunch, and no late suppers or midnight snacks.

5. Don’t move too fast

Avoid vigorous exercise for a couple of hours after eating. An after-dinner stroll is fine, but a more strenuous workout, especially if it involves bending over, can send acid into your oesophagus.

6. Sleep on an incline

Ideally, your head should be 6 to 8 inches higher than your feet. You can achieve this by using “extra-tall” bed risers on the legs supporting the head of your bed. If your sleeping partner objects to this change, try using a foam wedge support for your upper body. Don’t try to create a wedge by stacking pillows. They won’t provide the uniform support you need..

7. If you smoke, quit

Nicotine may relax the lower oesophageal sphincter.

9. Check your medications

Some—including postmenopausal oestrogen, tricyclic antidepressants, and anti-inflammatory painkillers—can relax the sphincter, while others—particularly bisphosphonates like alendronate (Fosamax), ibandronate (Boniva), or risedronate (Actonel), which are taken to increase bone density—can irritate the oesophagus.

10. Medications that may help your symptoms

A number of medications are available over the counter (OTC) for heartburn and other symptoms of reflux

These include:

• antacids that neutralize stomach acid, such as Liquid Gaviscon Advance this is best taken after food and before bedtime  

• H-2-receptor blockers that can decrease acid production in the stomach for up to 12 hours. An example of over the counter receptor blocker is ranitidine

• proton pump inhibitors (PPIs) that block acid production for long enough to enable the food pipe to heal. Examples of OTC preparations include lansoprazole and omeprazole. Nexium is a brand that can be bought from most chemists.

H-2 receptor blockers and PPIs are available from a doctor in a stronger, prescription-only form if OTC medications are not effective. It is not advisable to take these medications long term without medical supervision.

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