Understanding and Managing Reflux After Sleeve Gastrectomy

Sleeve gastrectomy, a popular weight loss surgery, involves reducing the stomach’s size to a slender, tube-like shape. While effective for weight loss, this procedure can lead to gastroesophageal reflux disease (GERD) in some patients. Studies indicate that approximately 30 percent of patients may experience new or worsened reflux symptoms post-surgery.

Causes of Post-Sleeve Reflux

The development of reflux after sleeve gastrectomy is multifaceted. The reduced stomach size increases internal pressure, which can overwhelm the lower oesophageal sphincter, allowing stomach acid to flow back into the oesophagus. Additionally, alterations in stomach anatomy during surgery can contribute to these symptoms.

Initial Management Strategies

For those experiencing reflux after sleeve gastrectomy, initial management includes lifestyle and dietary modifications:

Dietary Adjustments: Consume smaller, more frequent meals to reduce stomach pressure.
Avoid Triggers: Steer clear of foods and beverages known to exacerbate reflux, such as spicy foods, caffeine, and alcohol.
Timing: Avoid lying down immediately after eating and refrain from late-night meals.

If these measures are insufficient, medications like proton pump inhibitors (PPIs) or H2 blockers may be prescribed to reduce stomach acid production.

Advanced Treatment Options

In cases where lifestyle changes and medications do not alleviate severe reflux symptoms, surgical interventions may be considered:

Magnetic Sphincter Augmentation (MSA): This minimally invasive procedure involves placing a magnetic device around the lower oesophageal sphincter to enhance its function and prevent acid reflux. Recent studies suggest MSA as a promising alternative to traditional fundoplication for treating GERD after sleeve gastrectomy.
Conversion to Gastric Bypass: For patients with severe, persistent reflux or those who have regained weight, converting the sleeve gastrectomy to a Roux-en-Y gastric bypass can be effective. This procedure not only aids in further weight loss but also significantly reduces acid exposure to the oesophagus, alleviating reflux symptoms.

Personalised Care with Dr Jason Free

At Surgery Gold Coast, Dr Jason Free, a specialist bariatric surgeon, emphasises individualised treatment plans. Recognising that each patient’s experience with reflux post-sleeve gastrectomy is unique, Dr Free offers comprehensive consultations to determine the most appropriate management strategy, whether it involves lifestyle modifications, medication, or surgical intervention.

While reflux is a potential complication after sleeve gastrectomy, various effective management strategies are available. Early recognition and proactive management are crucial. Patients experiencing persistent reflux symptoms should consult with their healthcare provider to explore the best treatment options tailored to their needs.

For more information or to schedule a consultation, contact Surgery Gold Coast at 07 5564 6501 or visit surgerygoldcoast.com.au.