RNY is only choice for me

Jerry

Member
I was looking at the sleeve,then decided the DS was the best way to go.I have Barretts esophagus,so the doctor said my only option is the rny.I had an extra endoscope,but when the dr looked at it she said the rny was all she could do.Does that happen much?
 

southernlady

Administrator
Staff member
Welcome Jerry
I was looking at the sleeve,then decided the DS was the best way to go.I have Barretts esophagus,so the doctor said my only option is the rny.I had an extra endoscope,but when the dr looked at it she said the rny was all she could do.Does that happen much?
We’ve have one DSer who was diagnosed with Barrettes esophagus prior to his DS. He‘s done very well. So it’s not impossible but it is uncommon.
 

hilary1617

First time at the rodeo.
Hi and welcome Jerry ! It probably would be best to get a consultation with one of the true DS experts who are both very experienced with the DS and with patients who have other conditions. Specifically, it would be worth a visit to like Dr. Keshishian in California.
 

Larra

Well-Known Member
I would strongly recommend that you get a second opinion from one of the experienced DS surgeons. I don't know where you are so I don't know who to recommend, but I do know that surgeons with limited (or no) experience with the DS are not going to recommend it, and will seek reasons to default to the operations they are comfortable with. You are the one who will live with this decision, so take the time and effort to get the best advice possible to make a well informed decision.
 

Georgepds

Well-Known Member
I was looking at the sleeve,then decided the DS was the best way to go.I have Barretts esophagus,so the doctor said my only option is the rny.I had an extra endoscope,but when the dr looked at it she said the rny was all she could do.Does that happen much?

Not bad advice...Don't let enthusiasm for DS, and I'm an enthusiast, ignore the inceased risk of esophageal cancer for someone with Barrett's esophagus. The VSG part of DS increases the risk of GERD which exacerbates Barrett's esophagus

What it is

"Barrett's esophagus, tissue in the tube connecting your mouth and stomach (esophagus) is replaced by tissue similar to the intestinal lining.

Barrett's esophagus is often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. Only a small percentage of people with GERD will develop Barrett's esophagus.

Barrett's esophagus is associated with an increased risk of developing esophageal cancer. Although the risk is small, it's important to have regular checkups for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent esophageal cancer."

Risk factor

."Having GERD that doesn't get better when taking medications known as proton pump inhibitors or having GERD that requires regular medication can increase the risk of Barrett's esophagus."

Vsg/DS RISK

"Longer term risks .... Gastroesophageal reflux" (GERD)

Ref
[URL="http://www.mayoclinic.org/diseases-conditions/barretts-esophagus/symptoms-causes/syc-20352841[/URL]"]www.mayoclinic.org/diseases-conditions/barretts-esophagus/symptoms-causes/syc-20352841[/URL]

 

southernlady

Administrator
Staff member
The VSG part of DS increases the risk of GERD which exacerbates Barrett's esophagus
However, there is no guarantee that the RNY cures GERD. In fact, I’m aware of at least one RNYer who developed GERD after her surgery.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968207/
It never claims it cures GERD, just resolve most cases.
Just as the DS never claimed to cure diabetes but has the highest resolution rate.

I think this is a case where a person has to decide which way to go.

I was told by my first surgeon to get the RNY because of my GERD, totally overlooking my requirement for lifetime NSAID use. He told me to just go on opioids. I fired him.
 

Georgepds

Well-Known Member
However, there is no guarantee that the RNY cures GERD. In fact, I’m aware of at least one RNYer who developed GERD after her surgery.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968207/
It never claims it cures GERD, just resolve most cases.
Just as the DS never claimed to cure diabetes but has the highest resolution rate.

I think this is a case where a person has to decide which way to go.

I was told by my first surgeon to get the RNY because of my GERD, totally overlooking my requirement for lifetime NSAID use. He told me to just go on opioids. I fired him.
Agreed... but your risk profile was different. The OP already has Barrett's esophagus, the next risk is esophageal cancer

At your decision point you "only" had gerd ( I know... that's bad enough...)Your next major risk after gerd was Barrett's esophagus. The OP's next major risk is esophageal cancer


And.. as you imply.. these are risks.. not certainties.. but the relative proximity in the risk chain to cancer is enough to give serious consideration of alternatives

As to RNY curing gerd,well, I never said it did, but I know where that comes from. On OH, often a VSG patient with serious gerd will be revised to RNY. My understanding, and it is rudimentary at best, is absent a pyloric valve, acid reflux (gerd) is nearly impossible. Those with RNY have no pyloric valve in the digestive chain, those with normal or VSG/DS have a pyloric valve

The basic idea is without a pyloric valve all the stomach acid and contents leak directly into the small intestine
 
Last edited:

Sheanie

Well-Known Member
George, you know what increases GERD? Being obese. Internal pressure.

You know then, what reduces GERD? Losing weight.

The beauty of the DS is the flexibility of it. The sleeve can be made larger to accomodate the patient with GERD. The stomach can be made teensy tiny, as in my case, by a too-agressive surgeon, and NOT increase GERD. As in my case. Yup. I had GERD, but it disappeared post op.

For people with Barretts, doing nothing increases the cancer risk.

Its an individual choice. Obesity kills.
 

Larra

Well-Known Member
Georgepds the reason RNY helps most (not all) people with GERD is that the pouch is cut off from the part of the stomach that produces acid. Thus no acid can reflux up into the esophagus so, at least in theory, there should be no GERD.
Like you, I take the risk of esophageal cancer seriously. I still believe that a second opinion with an experienced DS surgeon is warranted. AS JackieOnLine pointed out, the size of the sleeve can be tailored to the needs of the patient. A more generous sleeve would be indicated for the OP if he does have a DS. In any event, there is no harm in getting a second opinion, which doesn't commit a patient to anything and is a good way to go into whatever operation well informed and confident of his decision.
 

Spiky Bugger

Well-Known Member
Then there’s some idiot here who developed GERD/Reflux from the freaking LapBand, because the band can really screw up the downhill traffic from mouth to stomach.

Luckily, she wised up and got the DS, but the esophageal damage and GERD did not go away.
 
Top