Is acid reflux after gastric sleeve common?
Yes. Many patients notice new or worsening reflux symptoms after their surgery, even if they never had issues before. It does not happen to everyone, but acid reflux is a commonly known side effect of gastric sleeve.
Why Does Acid Reflux Happen After Gastric Sleeve?
Acid reflux often happens after gastric sleeve because the surgery changed the shape and size of your stomach and the way it works. When your much smaller stomach fills with food, pressure can build and push acid up into the esophagus and trigger acid reflux.
The valve that normally keeps acid down may also become less effective. According to the Mayo Clinic, gastroesophageal reflux is listed as a known long-term risk of sleeve gastrectomy.
What Does Acid Reflux Feel Like After Gastric Sleeve Surgery?
Acid reflux can create a burning feeling in your chest that is often accompanied by a sour taste or food coming back up into your throat.
How Common Is Acid Reflux After Gastric Sleeve?
Acid reflux is fairly common after gastric sleeve surgery. UCLA Health reports that many studies show that about 30% of gastric sleeve patients may experience new reflux, even if they never had acid reflux before their surgery.
What Causes Acid Reflux After Gastric Sleeve?
Acid reflux can develop or become worse after gastric sleeve surgery. Some of the common causes include:
Higher Stomach Pressure and Valve Changes
After surgery, your smaller stomach fills up quickly. This can increase internal pressure and push acid up into your esophagus.
Hiatal Hernia or Anatomical Issues
Some patients may have a hiatal hernia or another structural issue that contributes to reflux. Doctors can use imaging or endoscopy to assess the situation and determine the best plan of care if symptoms continue.
Eating Habits That Can Make Acid Reflux Worse
Eating certain foods as well as other habits may increase reflux symptoms, including:
- Eating large meals
- Eating late at night
- Drinking too quickly
- Lying down soon after eating
Symptoms of Acid Reflux After Gastric Sleeve (and Warning Signs)
Typical symptoms may include the following:
- Burning feeling in the chest
- Sour or bitter taste in the mouth
- Food coming back up into the throat
- Coughing at night
- Throat irritation or hoarseness
When to Seek Medical Care
Sometimes, symptoms of acid reflux warrant immediate medical care. Some warning signs to look for include:
- Chest pain
- Trouble swallowing
- Vomiting blood
- Black stools
- Severe stomach pain
- Signs of dehydration
How to Reduce Acid Reflux After Gastric Sleeve Naturally
There may be some things you can try at home to help reduce symptoms of acid reflux.
Make Changes To Your Eating Habits
Small changes in how you eat can make a big difference. Some helpful habits may include:
- Eat smaller portions.
- Eat slowly and mindfully (do not multitask)
- Chew your food well.
- Sip beverages (water) instead of taking large gulps.
- Avoid eating too close to bedtime.
- Harvard Health recommends sitting in an upright position for one to two hours after eating.
Watch For Common Food Triggers
Some foods may make your symptoms worse. Common triggers include:
- Fatty or fried foods
- Spicy foods
- Citrus fruits
- Chocolate
- Caffeine
- Alcohol
Everyone can have different food triggers, so keeping a food journal and tracking your symptoms can help you figure out what foods cause issues for you.
Sleep Positioning
Propping your head on pillows to keep it elevated during sleep and avoiding lying down flat after eating may help lessen your symptoms.
If symptoms of reflux are new for you, or mild symptoms are worsening, or waking you up at night, schedule a follow-up with your bariatric team.
Medications And Tests For Acid Reflux After Gastric Sleeve
Your bariatric surgeon may recommend medication if your acid reflux after sleeve gastrectomy does not improve with diet and lifestyle changes. These medications can help reduce or control stomach acid and protect your esophagus.
Over-the-Counter vs. Prescription Options
Common medications may include:
- Antacids: can normally provide relief fairly quickly by neutralizing stomach acid.
- H2 blockers: reduce the amount of acid your stomach produces.
- Proton pump inhibitors (PPIs): Proton pump inhibitors (PPIs): are strong and can be more useful in reducing acid levels and helping the esophagus heal.
Some people do better using over-the-counter medicines, while others might need prescription-strength options to manage their symptoms.
When Testing May Be Needed
If your acid reflux continues or worsens, your doctor may recommend some testing to determine the underlying cause.
Common tests may include:
- Upper endoscopy (EGD) using a tiny camera that can get a close-up look at the esophagus and stomach
- Upper GI series (barium swallow) , which is a procedure that uses X-ray technology and a swallowed liquid to find issues like a hiatal hernia.
Follow Up Is Important
It is important that you make your doctor aware of any acid reflux issues you are experiencing after gastric sleeve.
Ongoing acid reflux can irritate and damage the esophagus over time. According to the Cleveland Clinic, chronic reflux may lead to inflammation and other complications if it is not treated.
What If Acid Reflux After Gastric Sleeve Does Not Improve?
If you have not been able to manage your acid reflux symptoms through changes in your diet & lifestyle or using medication, your bariatric doctor may recommend a medical procedure.
Fixing Mechanical Issues
If your symptoms are related to a hiatal hernia or another structural issue, surgery may help correct it. Your surgeon will examine your specific anatomy and evaluate your symptoms to decide if this is needed.
Conversion to Gastric Bypass
Sometimes doctors recommend that patients convert their gastric sleeve to a gastric bypass. This alters the pathway the acid travels through your digestive system and will often lessen the symptoms of reflux.
A retrospective review suggested that changing to a gastric bypass can improve reflux symptoms for many people, with some research showing improvement rates up to about 80%, although not everyone has complete relief.
According to Cedars-Sinai, conversion to gastric bypass often improves acid reflux after gastric sleeve, with many patients experiencing significant symptom relief, although some may still need medication.
What Results To Expect
Your treatment or revision may result in the following:
- Improvement in your reflux symptoms
- Some improvement in your symptoms, with an ongoing need for medication in some cases
- Results can vary from person to person based on differences in anatomy and how well the body heals after surgery.
Where Can I Get Help With Acid Reflux After Gastric Sleeve?
The team of experts at the Laparoscopic & Endoscopic Surgery Institute in Atlanta, Georgia, offers evaluation and treatment options for patients dealing with reflux after gastric sleeve.
Our board-certified doctors, Dr. Michael Williams, MD, FACS,FASMBS, and Dr. Brendon Curtis, MD, FACS, FASMBS, have decades of experience helping individuals suffering from obesity improve their health.
Set up a consultation today and learn more about your treatment options.
FAQs
Is Acid Reflux Normal Right After Gastric Sleeve Surgery?
Mild acid reflux after gastric sleeve can happen early as your body adjusts to the new stomach shape. However, ongoing or worsening symptoms should be evaluated by your doctor.
How Long Does Acid Reflux Last After Gastric Sleeve?
Acid reflux after gastric sleeve may improve within a few weeks for some patients as healing continues. Other individuals may have symptoms that last longer and require changes to their diet, using medication, or further evaluation.
Can Gastric Sleeve Cause GERD if I Never Had It Before?
Yes, acid reflux after gastric sleeve can develop even if you never had GERD before. This is often related to increased pressure in the stomach and changes to the valve that helps keep acid down.
What Foods Should I Avoid with Acid Reflux After Gastric Sleeve?
Foods that may worsen acid reflux after gastric sleeve include fatty or fried foods, spicy meals, citrus, chocolate, caffeine, and alcohol. Tracking your symptoms can help you identify your personal triggers.
When Do I Need an Endoscopy for Acid Reflux After Gastric Sleeve?
Your doctor may recommend an endoscopy if acid reflux after gastric sleeve does not improve with treatment or if symptoms such as trouble swallowing, persistent pain, or unexplained weight loss are present.
Will Converting to Gastric Bypass Stop Acid Reflux?
Yes, much of the time, converting to gastric bypass will help improve acid reflux after gastric sleeve by reducing pressure and changing how acid moves through the digestive system. Some patients may still need medication after surgery.
Can Acid Reflux Damage the Esophagus Over Time?
Ongoing acid reflux after gastric sleeve may irritate the esophagus over time. Proper treatment and follow-up care can help reduce the risk of long-term complications.
