Let me first preface this post by saying, I am not a doctor and am in no way able to give medical advice about anyone’s condition.
Did you know I’m having Revision to Bypass? Yep, sure am. My GERD issues have increases tri-fold (at least) since VSG. Don’t get it wrong, many people have vertical sleeve gastrectomy and do just fine with it. Many have minor reflux symptoms after VSG. Also, many have terrible problems after VSG. I am the latter of the cases. In my case, I actually had GERD for 5 years before VSG and should have been recommended against it.
VSG is notorious for increasing GERD/reflux symptoms. If you have not had weight loss surgery yet and already suffer with reflux, you should probably talk to your surgeon specifically about this issue when choosing which surgery to have. If you have already had VSG and are experiencing worsening symptoms, symptoms that are hindering your weight loss or just daily life in general, you might want to talk to your surgeon about a revision.
How You Get Reflux/GERD after VSG
There are a number of reasons why VSG can increase GERD. The procedure affects the intro-abdominal pressure. Meaning, since the stomach is cut down in size, the pressure is increased. This weakens the esophageal sphincter. The esophageal sphincter is a muscle that separates the esophagus from the stomach. Constant pressure weakens this barrier.
When you eat too much and stuff yourself, the contents of the stomach can also press against the esophageal sphincter. This can cause it to weaken. Stomach acids and food contents can slip through and back up the esophagus causing major discomfort.
It is also possible that a large gastric sleeve may have the capacity for increased acid production. This can cause reflux.
A hiatal hernia that goes unnoticed at the time of surgery or that develops afterward can also produce reflux symptoms.
In my case, as my current surgeon has explained, the postoperative angle of my sleeve increased intragastric pressure, causing my GERD to increase.
What is GERD
GERD is a digestive disease where your stomach acid or bile comes through the esophageal sphincter and irritates the food pipe lining. Acid reflux or heartburn is the same thing; however when you have it more than twice a week may indicate GERD.
It is usually self diagnosable. Symptoms include burning in the chest. This can come when lying down or sitting upright. It can include chest pain, stomach bloating, belching, dry cough, difficulty swallowing, regurgitation of sour liquid in throat, sensation of a lump in the throat.
Can Following diet and portion sizes help?
No diet has been proven to prevent or help GERD. Timing of meals and portion sizes can have an impact on it though. Certain foods may help ease pain. Some research shows that increasing fiber intake, specifically in the form of fruits and vegetables, may help protect against GERD.
Things that help:
Certain foods can trigger the reflux. Keeping a food log can help decipher which foods cause worse symptoms.
PPI’s or proton pump inhibitors cause a reduction in stomach acid; therefore, decreasing the amount of acid creeping back up the esophagus causing pain.
Elevating your head when lying down can help keep the acid down. Also, eating slowly and more then 2 hours before bed helps. You definitely want to stay alway from trigger foods. Spicy foods and high fat foods are common triggers.
When following diet doesn’t help GERD
When you follow all the advice you have researched or your doctor has advised and it still doesn’t help you may want to talk to your doctor for more advice. Specifically if you are a weight loss surgery candidate that has had VSG. If you have had VSG and your symptoms have worsened, no matter what you try to do, you may want to talk to your surgeon about a revision.
Long term damage to the esophagus can lead to serious irreversible diseases. Be sure to take care of yourself. If you haven’t had weight loss surgery yet and already have reflux or GERD, be sure to talk to your surgeon about which option is right for you.
Stay tuned for my next post which will be all about revision to Bypass, what lead to my decision, how I got approved, my countdown.