Share
While every bariatric procedure has the potential to reduce or even eliminate the diseases associated with morbid obesity, GERD or gastroesophageal reflux disease – chronic acid reflux that lasts for more than several weeks represents an interesting conundrum. On one hand, a procedure like the gastric sleeve is incredibly effective, but on the other, the method by which the stomach is made smaller may actually worsen existing GERD or may cause GERD de novo… new instances of GERD that never existed before.
We have also learned that patients with hiatal hernias are far more likely to experience GERD after a gastric sleeve, but even when a hiatal hernia is repaired during surgery, GERD can occur in a significant portion of the population.
How Do We manage This GERD Risk?
First, depending on the severity of the GERD, we may discuss the option of a gastric bypass versus the gastric sleeve or duodenal switch. The bypass is extremely effective at eliminating the symptoms of GERD and has not been proven to increase the risk of new or worsening acid reflux. For some, however, the gastric bypass is not the ideal option, and we can discuss how to manage the potential for GERD after a gastric sleeve.
Traditionally, a fundoplication procedure has been the surgical standard by which severe chronic acid reflex has been managed. However, a gastric sleeve cuts away and removes the fundus of the stomach, making a fundoplication impossible. For those patients and many others, a novel implantable procedure known as the LINX Reflux Management System may be a great option. This is a small, quarter size, bracelet made of titanium beads. During a short operation, your surgeon will wrap the bracelet around the lower portion of the esophagus or Lower Esophageal Sphincter and engage a magnetic clasp.
The LINX device adds extra pressure on the LES and, in upwards of 90% of cases, provides complete relief of symptoms. Further, because the device does not require suturing stomach tissue, it can be placed on patients who have undergone a gastric sleeve.
If you suffer from significant or debilitating acid reflux along with other obesity related diseases, we encourage you to come to our office for a consultation and learn more about the options available to you. From bariatric surgery to an acid reflux procedure, this will improve your life and lifestyle.
