DS and Acid Reflux

[Jon]

I am considering a revision from VSG to DS. It seems logical to me to do that since I am already half way there. I have talked to several surgeons and one surgeon told me that he wouldn't do DS on me because I have acid reflux and take meds for that. He said DS would make that issue worse for me. I have however found other surgeons that have no issue doing DS though with acid reflux and I found another surgeon that does something similar to DS called SADI-S and he claims that SADI-S is better for acid reflux people.

Has anyone here had acid reflux prior to having DS surgery? If you have, can you tell me if it made it worse, improved it, or was there no change?

I am right now debating if I should revise to Roux-en-y which would help with the acid reflux or DS which would cause more weight loss. I need an extreme procedure as I am pretty far overweight. I know a person where I live that had roux-en-y and gained most of her weight back so I am not real sold on that one either. I would appreciate your wisdom on this.

 

[Clematis]

Welcome Jon

First of all NO NO NO to the butchery that is RNY. Don;t even think about it. YES you will gain it back. Only a properly performed DS has the data to support long term success and resolution of comorbidities.

Second the addition of a traditional, two anastomoses switch with limb lengths based on the Hess method (zero data to support the efficacy of SIPS/SADI etc) should have no effect on GERD.

Yes, a VSG *may* cause GERD in some people but the addition of the switch has nothing to do with that. You've already had the VSG.

As for me, I had "silent" reflux pre-op. (I had no heartburn, just a clicking in one ear and the sensation that mucous was blocking the eustachian tube.) I was put on a PPI, clicking went away. I had the DS surgery two months later. No evidence of GERD post-op. However recently when I got off the PPIs and on to H2s (not an easy task), I then noticed heartburn unresolved by H2s, returned to a low dose PPI but, oddly, do not have full relief. I see a gastro in a few weeks to sort that out.

 

[southernlady]

I had GERD pre-op and I still have GERD. I preferred to chance keeping the GERD to all the hell of a RNY. Btw, a close friend of mine is a RNYer about 7 years out and her GERD is worse now than it ever was.

 

[Settledownnow]

No way on the RNY. No way. Your gut instincts are right.

 

[Larra]

The part of the DS that can cause or worsen GERD is the sleeve. You already have the sleeve. There is no reason to think that a SADI would either fix GERD or that it would cause less GERD than a real DS.
I have GERD. I had it before my DS also. I take Prilosec once/day and an occasional TUMS. I suppose I would not have GERD if I had had gastric bypass, but then again I would not have had such successful weight loss and maintenance of that weight loss. I'll take my Prilosec, thank you.

 

[DianaCox]

I had GERD before my DS and I still have it 14 years later. I have to take 2 Protonix a day. So I do. I just had an upper endoscopy to check my esophagus, and it is fine (I do have chronic gastritis, but the biopsies were OK). It bothers me a bit , but not more than being able to maintain a 120 lb weight loss and eat butter and steak to my heart's content.

If anything, adding the switch to the sleeve you already have will HELP if you have bile reflux, because the bile will be rerouted far away from your pyloric valve. And one of the risks of the SADI is developing NEW bile reflux. So NO to that. I wouldn't have had an RNY of any flavor - until I discovered the DS during my research in 2002, I was just about to give up on bariatric surgery, because I knew I could not tolerate the crapband or Ruined-and-Why barfing and dieting - and inevitable weight regain. When I researched the biology and lifestyle of the DS, it was like the heavens opened and angels sang - it immediately made sense to me, and I knew I could do it.

Not that I'm biased or anything.

 

[JackieOnLine]

Not that I'm biased or anything.