Acid refulx/Sleeve question

Hi all-

I joined this board when I started my Journey in June of last year. Reading everyones posts have been so helpful. When I decided I wanted to go through weight loss surgery I had my mind set on the VSG, however after a visit with the surgeon yesterday he is thinking that RYN is the best option for me. He stated that because I have a problem with severe acid reflux now he didnt think the sleeve was the best option because those who never experienced reflux come away from this surgery with having it. I was curious how many of you out there had reflux before your surgery and how did it impact the reflux after getting the sleeve? Surgeon scheduled a Upper GI next week to rule out a hyatil hernia ( spelling :() ....even though I had a scope done in july of last year and they said i didnt have a hernia. Surgeon also wanted to rule out any issues with my esophogus. He said once he saw the results of that test he could better speak to what my options are. I am unsure as what to do because the whole time I have been in this program i had my mind set on the sleeve. The thought of the RYN didnt appeal to me . lost and confused. Please share your thoughts. :)

A little about me

Starting weight 241.2 ( BMI 41)

Weight now - 223.6 ( BMI 37)

medical history - Cpap, acid reflux, arthritis, asthma, diverticulits

First of all, do you actually have reflux (medically diagnosed) and if you've been diagnosed, are you sure that's what you have?  Years ago I was diagnosed with GERD (reflux), but over time I realized I wasn't experiencing any real GERD symptoms and what I was experiencing was gas in my upper abdomen (very painful, feeels like an alien is about to burst out of your chest).  I don't get heartburn, and my endoscopy showed no signs of Barrett's esophagus.  I was truthful with the surgical team about what it was, even though it was previously diagnosed (incorrectly) as GERD.

But if in fact you have GERD (heartburn, taste of acid-food in the back of your throat, etc.) then, yes I hear the sleeve will exacerbate this problem.  So get your GERD under control first so that it no longer falls into the 'severe' reflux category.  And if you're set on the VSG, do so knowing that it could make your GERD symptoms worse in the long run. 

One of the docs on the surgical team tried to talk me into the RNY, but like you I wanted the VSG and I told him that's what I wanted, and I would not do the RNY.  I knew I would be so emotionally unhappy with doing that that I decided I would not even have WLS if it wasn't the VSG.  Ultimately, (no pun intended) check your gut - does having the RNY make you so unhappy that you wouldn't be successful?  Then don't do it.  If you're just feeling confused, take a bit of time to think about it first and then decide.  Whatever you do, it has to be right for you. 

Thanks for your thoughts and input. I was diagnosed with GERD and yes i do the get acid food in the back of the throat symptoms. I take a prescription for it daily. However i never had GERD during the times in my life when i have lost a signifanct amount of weight it only gives me issues with the times in my life when I am at my heavier points. I did really have my heart set on the VSG so i guess I will need to do some more research and have more discussions with my Dr to come to a resolution as to what is best. have never been so undecided on anything :( nice to know you per persistent and knew what you wanted and stuck to your guns..... Thank you again for your feedback its appreciated.

I have heartburn/reflux that is helped by daily prilosec. I usually take it a few days, off until symptoms start,  then back on. 

I, too, was worried about acid after the procedure. When I spoke to the surgeon,  I mentioned that it seemed to clear up when I had previously lost weight. He told me those were the magic words he looks for when determining if VSG is right for someone with reflux. 

Now,  you may not be the same but that was my experience. Ihad surgery last Monday and haven't had any issues yet,  but it's still early. I am on liquid ranitidine twice daily as well (not allowed whole pills).

I think you need to look deep in yourself and ask if you'd be happy with RNY. For me,  I wouldn't have it if VSG wasn't on the table. 

I hope your tests give you some insight and answers! Hopefully you and your surgeon will both end up happy with your procedure of choice. 

On the other hand,  I have also heard of others having acid come back several months later. 

I had fairly severe reflux before surgery - taking a ppi daily and suffered any time I skipped a dose.  I decided to still go with the sleeve because I believed it would be a more effective procedure for me personally.  Since surgery, my reflux was worse, but a doubled dose of ppi's, I don't experience any symptoms.  This choice is not for everyone, but for me, I feel it was the right one.

During my pre op testing, the doctor who performed my barium test didn't see any indication reflux. He did see that I had slow motility (my stomach empties slowly). I never have had a problem with heartburn, and my surgeon said that if I wanted to go ahead with VSG, I was good to go. When I started eating dense foods post op, I started having nausea when eating. Since I was alreayd on a PPI, which should have prevented reflux, My surgeon set up another barium test, which he wanted to be present for, to rule out ulcers. This test showed that my sleeve did slightly contract and push against it's contents (i.e. reflux). He sent me to a Gastroenterologist, who put me on a strong PPI. I don't have problems with nausea now, but am dealing with some acid issues that are mimicking hunger. Now, it's just a matter of finding the right PPI.

If you already have reflux (meaning that yor stomach contracts and sends its contents back up the esophagus), then it will likely intensify post op. In RARE cases, some patients experience an improvement of their symptoms, but it seems that they are the exception to the rule.

It's a matter of figuring out what's best for you. Do you want the sleeve, given that it was your first choice of WLS, aware that you will likely deal with reflux issues (protentially worse than now) from now on (remembering that symptoms can be medicated)? Or would you consider the RNY, which will basically eliminate reflux, even though it was not your first choice? Both surgeries can get you to the weight loss goal that you want. It's all about working with the tool that you have.

Best of luck in your decision! And good luck with your upper GI! Here's hoping for no hernias!

I never had acid reflux before surgery...and never have had it after..and i am almost 4 yrs postop

I was just like you, set on VSG.  My surgeon recommended RNY due to my GERD/reflux.  Mine was really bad I took Prilosec every morning and zantac 150 every night. 

I am completely cured since day 1 after RNY.  I am happy with my RNY.  Just wanted you to know :)

I am also cured of sleep apnea.