Gastric Sleeve and Acid Reflux

There are several studies on the connection between gastric sleeve and acid reflux. Different bariatric procedures can have different outcomes for GERD and acid reflux. It all depends on the individual case, whether or not acid reflux is treated with bariatric surgery. 

Bariatric surgery is one of the most effective ways to treat individuals suffering from severe obesity.

In this article, we talk about how to relieve acid reflux after gastric sleeve surgery and why you might have this problem. We explain the outcomes of gastric sleeve surgery that you should be aware of.

We also talk about options to consider if you're concerned about gastroesophageal reflux disease (GERD), but want to have weight-loss surgery.

 

Why Do I Have Acid Reflux After Gastric Sleeve Surgery?

GERD is a digestive disorder where stomach acid, food and fluids can travel back up the esophagus. It can be temporary or a long-term issue.

The result of gastric sleeve surgery is a smaller stomach which can increase pressure. About 75% of the stomach is removed in order to promote weight loss. 

gerd after gastric bypass

Another factor is the esophagogastric angle in a sleeve gastrectomy. This is the upward bend in your stomach just after the esophagus ends. 

This bend prevents stomach acid from traveling back up the esophagus. After bariatric surgery, this bend can be altered, leaving you with a greater risk of acid reflux.

As a result, studies have shown that the incidence of GERD can be increased after gastric sleeve surgery. If you are sticking to your bariatric diet and eating slowly, you may still experience acid reflux.

Weight gain after gastric sleeve surgery can make heartburn worse. It is not uncommon to experience occasional acid reflux and see heartburn as a side effect, but if the reflux becomes more frequent, with increased severity, a diagnosis of Gastroesophageal Reflux Disease (GERD) may then be considered. 

Pregnancy after gastric sleeve surgery can also trigger acid reflux.

 

How Can I Fix Acid Reflux After Gastric Sleeve Surgery?

Identify Your Heartburn Trigger Foods

There are certain foods and beverages that are likely to worsen reflux symptoms. Triggers may include chocolate, alcohol, citrus, mint, acidic foods, spicy foods, and fatty foods. It’s hard to give these up, but you might have limited options in your new bariatric diet.

Drinking alcohol after gastric sleeve surgery is typically not recommended anyway. Alcohol can damage the esophagus and increase GERD symptoms. 

Think about what foods you can replace these options with and still enjoy. Some individuals find relief with lean meats and proteins (poultry, fish, tofu, beans, etc.), limiting high fat (butter, fried foods, pastries, etc.), consuming baked options instead of fried, and choosing complex carbohydrates (whole grains, vegetables, etc.).

It is also recommended to eat smaller, more frequent meals to avoid overeating. An option that may help are bariatric protein meal replacements as a smaller meal and easier on the go option. You may also look into a bariatric portion plate that can help you follow smaller portions. 

Keep Heartburn Medication on Hand

Typically, bariatric patients are slowly taken off of antacids after bariatric surgery, as weight loss can provide relief of acid reflux. However, if you have had bariatric surgery and are still experiencing acid reflux symptoms, make sure to have antacids on hand.

Try to avoid wine, coffee, soda, or citrus. It is also recommended to not consume beverages at the same time you are eating. One of the reasons being that your new stomach is so small, drinking and eating at the same time can cause a number of issues including acid reflux.

Keep Your Body Upright

Avoid eating late at night because it can increase gastric acid production. Laying down right after eating may result in heartburn and acid reflux. Plan to not lay down for at least 1 hour after eating.

Meal planning can help with scheduling, this way you eat around the same time everyday. This will limit consuming meals too close to bedtime.

Certain types of exercise can also cause acid reflux like some yoga poses. Avoid activities that can push acid upwards, especially around mealtime. Consider using suitable equipment, like a bariatric exercise bike.

 

Which Bariatric Surgery is Best For Acid Reflux?

Obesity has been linked with an increased diagnosis of GERD. It has been shown that individuals with a BMI above 30 are 2.5 times more likely to have acid reflux than people with a lower BMI. For those who already deal with acid reflux, the thought of it worsening after bariatric surgery can be upsetting.

There are a few options in order to overcome GERD while still having weight loss surgery. We list some of the options below. 

Gastric Bypass Instead of a Gastric Sleeve

If you are seriously concerned about GERD, you may want to consider gastric bypass. Those who are diagnosed with GERD or acid reflux before weight loss surgery are more likely to be recommended Roux-en-Y gastric bypass by their healthcare provider because it has been an effective method in decreasing GERD symptoms.

Unlike a laparoscopic gastric sleeve, gastric bypass is less likely to alter pressure in the stomach. Another reason GERD may improve after a gastric bypass is that your stomach produces less acid. 

GERD after gastric bypass surgery is still possible. Acid reflux can start up again years after bariatric surgery. There may be other complications occurring that you may not know about causing further issues with acid reflux.

You may have tried medications that are usually effective for GERD, like proton pump inhibitors (PPIs). When there are little results being seen with PPI medication, there could be another problem to blame.

It is always recommended to consult with your healthcare provider and surgeon when you are having severe acid reflux. They will be able to do tests to identify the problem. Further surgery may be recommended in order to resolve GERD.

Hernia Repair With Gastric Sleeve Surgery

gastric sleeve and gerd

If you have persisting acid reflux before bariatric surgery, you may have other issues going on, such as a hiatal hernia.

A hiatal hernia occurs when a portion of the stomach pushes through, or bulges, through the diaphragm. This can cause food and acid to flow back into the esophagus causing heartburn and further symptoms. 

During gastric sleeve surgery, the surgeon can look for ways to reduce the chance of GERD post-op. If a hiatal hernia is present during the time of gastric sleeve surgery, it can be repaired during the procedure.

Ask Your Doctor About the Latest Medical Developments

For those with chronic GERD, it’s worthwhile to take a look at recent medical advances. Some of these options are still relatively new. More research is required to prove effectiveness and safety.

One of these options is the LINX reflux device. This device does not require permanent alteration to the gastrointestinal tract. It goes around the lower esophageal sphincter where your esophagus and stomach meet in order to prevent acid from backing up into the esophagus. The procedure is low-risk, and the device can be removed if there are complications.

You might be able to have a LINX device after you have a gastric sleeve. Studies are ongoing to prove the effectiveness.

 

Other Bariatric Articles to Read

There’s plenty to learn on your journey as a bariatric patient. Check out the following selection:

  1. Acid Reflux Or GERD After Bariatric Surgery - 3 Tips!
  2. What Pain Medication Can You Take After Gastric Bypass?
  3. What Are The Best Vitamins After Bariatric Surgery?
  4. Bariatric Recipes
  5. Recovery After Gastric Bypass Surgery
  6. Bariatric Resources
  7. Weight Loss Surgery: Issues to Consider
  8. Setting Realistic Goals and Staying Motivated After Bariatrics
  9. 5 Tips To Healthy Eating After Bariatric Surgery
  10. Gallbladder Problems After Gastric Bypass Surgery
  11. Pregnancy After Gastric Bypass
  12. Sleep Apnea and Bariatric Surgery
  13. Life After Weight Loss Surgery: 5 Things You Should Know
  14. Taste Change After Weight Loss Surgery
  15. Probiotics for Bariatric Patients

 

 **This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.