VSG revision options due to GERD

[jenf428]

Hi all! I had VSG in 2015, lost 100lbs but have gradually gained 45lbs back in the past 3 years or so. Also my GERD has gotten horrendous, along with a large Hiatal Hernia that comes with horrible flu like symptoms a few times a month due to pressure on the Vagus nerve. I can not live with this HH and although new medication is helping quite a bit with the acid reflux, I'd like to get off of it at some point as I hear it's bad news long term. From what I am told, Gastric Bypass would be the best option due to the main reason for revision being GERD and HH repair. I should mention I also had a HH repair done when I got my sleeve, so that repair was not permanent. I am reading so much benefit of the DS, and how it is the natural progression from the sleeve with better malabsorption, now I'm wondering if it would be a better option? I would love the benefit of getting rid of these gained back lbs as well as the GERD. But to be honest I would not be getting the revision if it was only for weight loss. The GERD and HH are top priority. Has anyone successfully cured GERD long term with the DS procedure? Pro's and Con's of each surgery from VSG? Thanks to everyone!

 

[southernlady]

Welcome, jenf428

I‘ll let others answer your question.

 

[Webmommy]

Welcome! Since your vagus nerve is involved I would be very interested in making sure that I consulted with someone who’s on the official list here and who has lots of years of experience doing the DS and GI surgeries.

 

[Larra]

I'm sorry Georgepds but some of the info you provided is incorrect.
The reason RNY gastric bypass helps with GERD is that the pouch is no longer connected to the part of the stomach where acid is produced. Thus, acid, even if still being produced, can't get up into the esophagus. Of course, the potential drawback to this is that there could still be acid in the blind stomach, and this part of the stomach can't be assessed with standard diagnostic studies. Now, how much of a problem this might be with a stomach that has already been largely removed with a VSG, I don't know. Losing more weight and possibly having a HH repaired can also help with GERD, though how much in any individual case, I don't know if anyone can predict ahead of time.
The other incorrect info is your statement that part of the small intestine is resected with RNY gastric bypass. Actually, nothing is resected with this operation, it's just that a small portion of the small intestine is bypassed and reconnected to the pouch portion of the stomach. It's true that the amount bypassed can be either proximal (not much) or distal, but most bariatric surgeons routinely do proximal.
With the DS, of course, part of the stomach is resected with the VSG portion, but the OP has already had this done.

 

[hilary1617]

Hi and welcome jenf428 ! I'm sorry that you are experiencing GERD. I have a small HH and had a DS (and love it), but GERD has never been an issue so I can only imagine. All the best!

 

[Spiky Bugger]

I'm sorry Georgepds but some of the info you provided is incorrect.
The reason RNY gastric bypass helps with GERD is that the pouch is no longer connected to the part of the stomach where acid is produced. Thus, acid, even if still being produced, can't get up into the esophagus. Of course, the potential drawback to this is that there could still be acid in the blind stomach, and this part of the stomach can't be assessed with standard diagnostic studies. Now, how much of a problem this might be with a stomach that has already been largely removed with a VSG, I don't know. Losing more weight and possibly having a HH repaired can also help with GERD, though how much in any individual case, I don't know if anyone can predict ahead of time.
The other incorrect info is your statement that part of the small intestine is resected with RNY gastric bypass. Actually, nothing is resected with this operation, it's just that a small portion of the small intestine is bypassed and reconnected to the pouch portion of the stomach. It's true that the amount bypassed can be either proximal (not much) or distal, but most bariatric surgeons routinely do proximal.
With the DS, of course, part of the stomach is resected with the VSG portion, but the OP has already had this done.

Just throwing this out there...

As of about ten minutes ago, I decided the GERD/Reflux issue, in my case, might be addressed by reviewing my eating practices. Silent conversation in my head regarding the reflux thing, which started w/LapBand, led to my CURRENT (probably faulty) assumptions/observations/random ideas:

•With the band, and continuing with the DS, I started having reflux.
•With the band and the DS, I ate smaller meals/snacks, quite often.
•Gastric acids are produced, or so says Dr. Wikipedia, when our bodies think we need acids to digest meals.
•So every time I eat anything, I’m telling my gut to make more acid.
•MY (stupid) response to all that acid is to try to “fix” it, like with a banana or something soothing.
•At which point, my gut PROBABLY thinks it's time for more acid.
•My PPIs are not solving the problem.

Signed,
The Not Sharpest Knife in the Drawer

 

[JackieOnLine]

My PPIs are not solving the problem.

Signed,
The Not Sharpest Knife in the Drawer

I hear you: I do all kinds of things that make my acid worse like drink coffee and eat too much and too often.

and I wish I was half as sharp as you!!!