WLS Acid reflux

Bariatric surgery and GERD

Gastro oesophageal reflux disease (GERD) is a condition of the esophagus that causes heartburn after eating certain foods

Indigestion is when stomach acids leak into the oesophagus causing that unpleasant burning sensation known as heartburn or acid reflux. GERD is chronic heartburn which flares up easily and often after eating. People with GERD know to steer clear of trigger foods like tomatoes, onions, alcohol or fruit juice.

What is the esophagus?

It is a muscular tube around 8 inches long that connects the throat to the stomach. Near the throat sits a group of muscles that we use to eat, swallow, gulp, burp and vomit. These muscles are called the upper esophagus sphincter (UES) and they prevent food from entering the windpipe and causing choking.

The lower esophageal sphincter (LES) connects to the stomach at the latter end of the tube. The LES works like a valve to prevent stomach contents from escaping backwards into the esophagus causing pain and discomfort. If the LES is weak or impaired it will fail to close properly once food has been swallowed. 

Most people experience indigestion on and off throughout life. However, GERD is a set of chronic, persistent symptoms which can lead to more serious complications with the esophagus.

People who smoke and/or are overweight are more likely to suffer with GERD. Fortunately the disease responds well to health and lifestyle improvements and can be reversed by losing weight, drinking less alcohol, eating small, healthy portions and stopping smoking.

Bariatric surgery and GERD

Many bariatric surgery patients find that symptoms improve as they lose weight. However, bariatric surgeries affect GERD differently. The two main differences are reported in Roux en-Y Gastric bypass (RYGB) patients and gastric sleeve patients. You can read more here 

According to research published in the journal of the National Centre for Biotechnology Information 'the RYGB was considered an effective method to alleviate symptoms of GERD, whereas laparoscopic sleeve gastrectomy appeared to increase the incidence of the disease.'

GERD and Sleeve Gastrectomy

Out of 28 patients tested for GERD 18 per cent were found to have 'new onset GERD' after having laparoscopic sleeve gastrectomy. 

If you have GERD or have developed a problem with indigestion after surgery then your symptoms can be helped with a specially formed diet plan and antacid medications.

Changing your diet can help your GERD

Trial and error is the best way to establish a diet that works for you. Identify which food and drink triggers your heartburn and look for tasty alternatives that don't aggravate the symptoms. For instance, if kiwis and citrus fruits trigger heartburn then stop eating those and try bananas, apples or plums for a change. If you think the mozzarella on your margarita is causing you bother then try a goat cheese topping on your pizza instead.

Symptoms, causes and complications

Heartburn is caused when acid escapes from the stomach past the UES muscle and into the esophagus. Frequent heartburn can damage the lining of the oesophagus and cause the tube to narrow which is also known as strictures.

If after having the sleeve GERD has become a big problem then your GP and surgeon can help. In the few cases where medication and dietary controls aren't effective then revisional surgery or a conversion to gastric bypass could be necessary for permanent relief.