Acid Reflux and Bariatric Surgery: Part 1

Acid reflux is a common complaint both before and after weight loss surgery. You may see the acronym GERD used in your medical record (gastroesophageal reflux disease).  Often, the main treatment for severe reflux is having bypass surgery done.  While surgery is used as a treatment for reflux, it can also be a cause of new reflux appearing post-operatively.

After gastric bypass, acid reflux is rare, but not impossible. This type of bariatric surgery is a common surgical treatment for severe reflux after pharmacotherapies and lifestyle interventions have failed. If you are experiencing symptoms of reflux after a bypass, we recommend scheduling an appointment with your weight loss surgeon.  Your symptoms may be caused by a hiatal hernia recurrence or an anatomic issue that can be corrected with surgery.

On the flip side, a sleeve gastrectomy often causes new onset of reflux in patients. Unfortunately, there is no way to predict who will be more likely to have reflux after a sleeve and it is a risk taken by having this type of surgery. Reflux after a sleeve may be caused by the shape of the stomach – where a sharp bend that can increase the pressure in the lumen of the stomach and create reflux. If you are experiencing reflux after a sleeve gastrectomy, schedule with your surgeon about treatments available to help manage symptoms.

Another common cause of reflux after surgery is eating behaviors. We frequently see patients who simply needed to change how and what they are eating in order to relieve their reflux. It can help to eat in a relaxed manner and in an upright position. Digestion is regulated by your parasympathetic nervous system and can be “primed” by having a calm and distraction free eating environment. Weight regain, even as little as 5-10 pounds, can cause reflux to arise. Often the first place weight is gained is called visceral fat (around the organs). This extra fat creates pressure in your belly and against your stomach which increases reflux.

Make sure to:

1. Slow down while eating

2. Eat while seated upright with no distractions

3. Monitor for weight regain

Stay tuned for part 2!

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