RNY Gastric Bypass as a solution for GERD after weight loss surgery.
Occasionally patients who get a Lap Band or a Gastric Sleeve may experience acid reflux or GERD that is not caused by a physical component by a hiatal hernia for instance, and is no longer being controlled by taking medication, changing their eating habits, or losing weight.
In these cases, patients need to consider a surgical solution to this problem before a serious consequence like Barrett’s Esophagus presents itself. Barrett’s esophagus is when the esophagus’ normal lining tissue changes to resemble the lining tissue of the intestines, it thickens and becomes red. Barrett’s esophagus increases the risk of cancer of the esophagus. It is estimated that approximately 10% of patients with GERD will develop Barrett’s esophagus.
How the RNY Gastric Bypass helps resolve GERD.
In a gastric bypass procedure, the surgeon will create a small pouch in the upper part of the stomach and connect it to the duodenum to empty food into the rest of the intestines. The rest of the stomach, where the majority of the acid is produced is not connected to this small holding pouch which is the new stomach. This separation does not permit acid to travel back from the stomach to the esophagus like before surgery so the situation is resolved.
The small pouch or new stomach does produce a little bit of acid especially due to the staples being used during the procedure but not enough to cause problems like before surgery. A few months after surgery, during which patients continue to use PPIs, GERD is resolved without the need for medication.
It is important to note that the Mini Gastric Bypass (MGB) is not recommended in this situation and that an MGB may cause biliary reflux which is actually more difficult to resolve with medication than GERD.
When to consider revising a weight loss surgery to an RNY Gastric Bypass?
You have GERD symptoms not controlled with high dosages of medication.
You are having side effects due to the medication taken for GERD.
You wish to avoid taking acid-inhibiting medication for long periods.