Reflux After Weight Loss Surgery

Is it normal to experience reflux following weight loss surgery?

Dr Kuzinkovas explores the cause of acid reflux following weight loss surgery and takes a look at the most effective treatments.

What is reflux?

Gastric reflux is caused by stomach acid rising up the digestive tract. Gastro-oesophageal reflux disease (GORD) causes symptoms such as heartburn, indigestion and regurgitation. For most individuals, GORD can be treated with over-the-counter anti-acid medications combined with lifestyle changes. Moderating the intake of coffee, and alcohol and reducing portion size of meals are common recommendations. 

Reflux following weight loss surgery

Individuals who have undergone weight loss surgery may experience gastric acid reflux. Certain procedures such as Lap Band surgery and gastric sleeve surgery are known to have higher occurrences of gastric acid reflux due to changes in the individual’s digestive system. These changes can alter an individual’s ability to retain digestive acids in the stomach.  

Lap Band surgery and acid reflux 

For individuals who have undergone Lap Band surgery, the newly created gastric pouch has a smaller capacity for food and liquid. This reduction in the size of the gastric pouch, combined with increased pressure in the gastric pouch can result in heartburn, indigestion and regurgitation and may require a period of adjustment. 

Lap Band Reflux Treatment 

Gastric reflux symptoms can also indicate that a gastric band is too tight and may require adjustment. Once the patient has adjusted to a new diet and the band has been adjusted, the symptoms of acid reflux should improve. Anti-acid medication may also be recommended to help manage the symptoms. 

If reflux symptoms are severe, Lap Band removal may be recommended to avoid further complications such as esophagitis (inflammation of the esophagus). Bariatric revision surgery may also be recommended to help a patient achieve their further weight loss goals. 

Gastric sleeve and acid reflux

Gastric sleeve surgery is considered moderately invasive and involves the removal of approximately 75% of the stomach. The reduction in size of the stomach results in an increased intra-gastric pressure which can put additional stress on the lower oesophageal sphincter. This increase in pressure can cause stomach contents to travel up the oesophagus and cause heartburn and indigestion. It is important to note that some patients experience a reduction in intra-gastric pressure and experience a reduction in the symptoms of acid reflux. 

Gastric sleeve reflux treatment

Treating acid reflux symptoms following Gastric Sleeve Surgery begins with adjustments to food intake and can involve either over-the-counter or prescription medications. For patients who experience severe reflux and heartburn that doesn’t improve, bariatric revision surgery may be recommended. 

Revision surgery from gastric sleeve to gastric bypass [link] is a known treatment for severe gastric reflux. During the procedure, the digestive tract is adjusted to bypass a large portion of the stomach and upper intestine. These changes work to reduce the pressure onto the lower esophageal sphincter and prevent release of stomach contents into the esophagus. 

Conversion to gastric bypass

Severe acid reflux can reduce an individual’s quality of life and shouldn’t be ignored. Ongoing exposure to gastric juices can cause oesophageal ulceration, bleeding and in some cases, Barrett’s oesophagus, a pre-cancerous condition that left untreated can develop into oesophageal cancer. If you think you have a medical emergency please visit your nearest hospital emergency department or call your local emergency services immediately. 

If you’d like to speak to Dr Kuzinkovas about improving your acid reflux symptoms please do not hesitate to speak to our team today by contacting our clinic on 1300 551 533.

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