Is converting the gastric sleeve to the gastric bypass an effective solution to chronic gastritis and GERD?

Question Below Submitted By:  

Liz (a patient from Virginia)

My name is Liz and I am 3 months post-op of the gastric sleeve surgery. I decided to have the gastric sleeve surgery after being recommended for it by my OB/GYN.

I spent a 10 months in the planning stage prior to surgery with all of the required diet modifications, group therapy sessions, exercise program and required weight loss of 10 pounds prior to my surgery date being scheduled. I have done everything that has been required and then some.

After my surgery I had absolutely NO appetite. To this day I still have no appetite. If I was not reminded to eat or drink something I would never even think of doing so. I actually have a kind of aversion to eating. Kind of scary for me since I used to have a love affair with my food!

The problem is that since the surgery I have not only developed an aversion and intolerance to protein (actually makes me sick) but eating AND drinking actually hurts. It hurts whenever anything goes down my esophagus and into my stomach.

I am still drinking protein drinks….usually only the Ensure clears (the only ones I can handle) and lots of milk. I am being seen by my dietitian every 2 weeks and following the diet he has given me.

I just had an EGD done and was told that I have chronic gastritis? Now my surgeon wants to talk about converting my sleeve to a bypass.

My question is whether or not this will be effective in stopping the gastritis. If the acid is produced in my stomach won’t it still be producing or over producing it? And if so how will this help my problem?

With the sleeve I have already lost 78 pounds and I feel a lot better if I don’t eat or drink anything.

Any advice would be helpful!

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01.

Expert Responses to the Question Above

Bariatric surgeon at CBGSA , Arcadia , California

by: Dr. Troy LaMar

Hi Liz,

Well, you certainly have lost a lot of weight in 3 months.

Having a sleeve gastrectomy can decrease the appetite since the level of Grehlin (appetite hormone) goes down. But, almost always, the appetite will come back with time.

However, you should be able to get some proteins and fluids in... eggs, yogurt, thinly sliced turkey, lean ground beef, fish etc. Your dietician should be able to help you figure out how to get 80 grams of protein/day between regular protein and shakes. Usually post op gastritis after a sleeve should improve with antacids and carafate over time.

However, conversion to a gastric bypass can decrease the amount of acid in the pouch since no acid can get to the pouch in a gastric bypass patient (because the stomach is divided away from the portion of the stomach that acid is made).

Will your appetite come back just because you convert to a gastric bypass? One can not be sure about that... again, usually with time it will return. Discuss again in depth with your surgeon the option of conversion, but probably after some treatment of your gastritis.

Good luck,

Sincerely,
Troy LaMar M.D.

los angeles bariatric surgeon

(click here for Dr. LaMar's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Complications & Risks of Gastric Sleeve Surgery

02.

Patient Responses to the Question Above

GERD

by: Anonymous

My wife had lapband for 10 years and had bad reflux for the last few years. She just revised to gastric bypass in September and the reflux is no longer a problem. I just had bypass 3 days ago so don't have experience yet but so far I haven't been hungry at all and no reflux.

i think i need the gastric bypass even tho i had the sleeve

by: Anonymous

I had the gastric sleeve done and did great transitioning to new habits. Before surgery I was 254, lost down to 212 but went back up to 247 and then weighed 244 day of sleeve surgery. I'm down to 209 but that's as far as I'm able to go for some reason. Now I'm noticing GERD again and there are times it almost strangles me at night! If tube gastric bypass can help me with this horrible acid that crimes up into throat and help me get to my best weight. I'm interested!!!

GERD

by: 100 lbs lost

Yes. I have lost 120lbs in 14months. I look great but have severe GERD. I am having the revision from the sleeve to the bypass and will be overjoyed when these painful symptoms are gone. I believe I will have a better quality of life.

How's it going?

by: Kissiah

Your situation a sounds exactly like what I am going through now. Did you end up going through with the RNY? If so, how is it working for you? Let me know! Thanks! :)

Gerd and gastric sleeve to now bypasd

by: Terri

Like the all of the people in the stories above, I to suffered from extreme Gerd and also a hernia after 10 years post gastric sleeve. With in the past 5 months I was in and out of ER, eating habits changed from being able to eat to not being able to due to GERD and now constipation. I was referred to a G.I. Specialist, under went every imaging test including EGD and Colon, still didn't find any answers. I finally ended up in the hospital for over a week as I couldn't work, eat, or poop. Meet with bariatric team, who ordered a few more test and talked with my G.I. End result was converting to full bypass. So here it is a week post bypass. No GERD, no constipation, so I know switching to bypass helped me with that. Now have to adjust to the beginning of things.

Sleeve to Bypass

by: Lori

I had the sleeve implanted in July 2015. I had to have more surgery in May of this year for adhesions and a "twisted" stomach. I have been vomiting my food since last year and it's hard for me to keep any protein down other than shakes and soft foods.

My surgeon is telling me about revision to a bypass due to my vomiting and the fact my stomach is getting twisted again after 4 months. I was so scared to hear this. Just the thought of another surgery scares me. I just want to feel better and be able to eat somewhat normally without vomiting. I always expected after the sleeve that I wouldn't be able to eat a lot of food, but at this point I can't eat solids at all without vomiting 5 minutes later.

I would love to hear from anyone with similar issues and can offer me some information and encouragement. Yes I am down 70 pounds but I don't feel healthy which was my goal from the start. I've become very depressed and it is affecting my daily living. Thank you!

Gastric Sleeve Converted to Roux en Y due to GERD

by: Perry

Hi all. I had gastric sleeve surgery November, 2015. Two weeks afterwards, I was unable to even keep water down. It was attributed to GERD (reflux). I was on TPN for some time, and lost over 100 pounds in the months I had to wait to heal up enough to have the Roux en Y conversion surgery.

I had the Roux en Y surgery at the end of April, 2016. Since then, I have been able to drink, eat, etc., following a very conservative re-introduction of food after not having anything by mouth for five months.

I am now, in October 2016, down 130 pounds, at my goal weight, and I am able to eat and drink - the amounts are depending on the "wetness" of the food - I can eat 4 ounces of soup/chili/etc., two soft boiled eggs, or 1-2 ounces of fish, shrimp, scallops, or chicken, or mayonnaise-based salads like egg salad, tuna salad, etc. I have not tried things like salad or steak, yet, and frankly, I'm in no hurry to. (Wendy's Chili has been a godsend. *grin*)

Needless to say, the time between November 2015 and April 2016 was a hellish nightmare. I'm so glad that I have the conversion from sleeve to bypass!

Gerd and gastric sleeve to bypasd

by: Liz.P

I had a Gastric Sleeve in June 22, 2015. I was 283.6 lbs. My total weight lost was 88 pounds at the beginning. Now my weight is gradually creeping up. I also have Gerd and reflux, which is a constant tightness in my throat and between my breast-diaphragm, it’s feeling like it strangles me all the time. I do exercise and try to drink plenty water. Now it hurts whenever anything goes down into my stomach. Today my weight is 223 pounds, did I choose the right Bariatric Surgery. I was over 50 BMI with several comorbidities and other diagnoses. I am now 39.5. My question is will Medicare pay for a second surgery. Please can you help me.
Regards
Liz

GERD revision surgery

by: GERD

Hello All- I'm reading your stories about revision from sleeve to bypass and I'm right in the middle of this battle myself. I had the sleeve done 10/2015 but I have had miserable reflux since then. I have had many UGIs that confirms the GERD. I have been on protonix since my surgery but I'm really struggling. I have a surgeon now who wants to do bypass but my insurance is denying it because I don't meet bariatric criteria. I just wrote my own appeal letter explaining the revision is not for weight loss reasons but to cure the GERD. Does anyone know how to get insurance to approve the revision to cure the reflux?

Sleeve revision

by: Nancy crane

I am 1 week post op from sleeve to RNY, I had severe GERD. I am a little nervous though, I have been very hungry...

I'm praying this is in my head hunger, but on a brighter note, NO MORE ACID REFLUX! I feel pretty good considering it was a big surgery.

If you're option is to do this, I recommend it highly.

i revised from Sleeve to bypass

by: Melissa

I had a sleeve Feb 2015 and had horrendous reflux/heartburn straight after surgery, I did, however, lose 6 stone in weight but revised to bypass May 2017.

I feel great!!! No more heartburn, no reflux...I'm sleeping better as I'm not waking up with a mouthful of hot watery acid.

I do feel that I had much better restriction from the sleeve and that I am able to eat and drink much more in quantity, which worries me slightly as I don't want to put on any of the weight I lost with my initial sleeve.

All I can say is that I feel like a different person now I have had my bypass.

GERD/Gastritis after Gastric Bypass

by: Angie

I opted for bypass specifically because I had been living with GERD for years, and was told that bypass would eliminate my GERD, however, 4 weeks post-op, not only was my GERD In overdrive, but now I have gastritis to boot! I am not a happy camper. I am hoping that this is just a case of things getting worse before getting better.

Try Lactaid

by: 2 months out

Try Lactaid instead of milk.

It helped me a lot and I had never had problems that required Lactose free options prior to surgery.

Informstiin

by: Lisa

I had the gastric sleeve done about 6 years ago , went well for awhile but didn't have the right mindset then..anyway is it possible to have the gastric bypass after already doing the other?

Had the gastric sleeve

by: Dora

I had the gastric sleeve done December 22nd, 2017 and I'm experiencing a lot of burping like acid in my stomach. Now I'm like 4 weeks post-op and I'm on tpn in the doctors talking about me converting to a gastric bypass. I am very afraid, I don't want another surgery but I just want some feedback on if this would help me or not. Or would it just put me in a bad position?

If anyone has any advice for me please send me a message and let me know if you've experienced any of this I've been on the tpn for 3 weeks now. I'm just wondering will things get better they've had me on several different medicines that had me on the Reglan, have also had me on me on Protonix.

They've had me on Prilosec so nothing seems to be working for me, so I just want to get a word back from someone to know if the gastric bypass will be okay to do. I'm just nervous and scared and don't know what to do with this point.

Conversion from Sleeve to Bypass

by: Meredith

I have read all the comments with people being scared about progressing from the sleeve to the bypass and let me tell you it is a life changer.

I had horrendous acid reflux where I could only drink 1/4 cup of water and my chest would start burning. Also later at night I would wake up in coughing fits where I was coughing so violently I would wreck my voice.

So if you have had acid reflux from the sleeve or prior, consider getting the bypass. I am now able to drink at least 2 glasses at a time, and don't feel as constipated anymore.

Sleeve

by: Sarah

I’m about to have a gastric sleeve but I’m not sure I’m doing the right thing ? I previously was banded and when it slipped I had horrific gerd.

I’ve since had the band removed and no more GERD. I’m not sure if I should just have the bypass as I’m paying for surgery and can’t afford sleeve and then bypass a year down the line ?!

I’d go with the bypass...

by: Sydcel

Before WLS I had terrible GERD, and had been on prescription antacids for about 15 years. I was told that many sleeve patients would get GERD as a result of sleeve surgery, and I really wanted off those meds, so I opted for the bypass.

NO MORE GERD!!!! YEEAAAAAA! Unless there are other considerations you haven’t shared, I’d go bypass to avoid the potential of having two surgeries. Either way, you should definitely discuss your concerns with your doctor. Best of luck to you!

acid reflux

by: sue

I have been reading everyone's comments and concerns. I had my sleeve done in Nov 2014. I did great lost 85 lbs but gained 40 back in the last year 4 months after my sleeve my gallbladder failed and had it removed. Been dealing with lots of heartburn and had to go thru many testing to make sure there wasn't anything else causing the issue.

Had upper GI testing with xray imaging and then endoscopy and colonoscopy and then had to do the Bravo test for PH levels also done thru endoscopy. My Dr's are great and my Dr. had explained to me that I am really far out from surgery to have these issues with reflux heartburn etc. But I do my endo/colonoscopy all came back normal, but my Bravo test came back extremely high.

Now my Doctor is writing the insurance company of the issues that i have in order to get it covered by the insurance. Don't give up on having the procedure done. I cant wait for the surgery day because something has to be better then this.

I need a revision to fix GERD

by: Wendy Sobczyk

I'm in a similar situation. I am currently waiting, after six months of multiple doctor appointments and procedures- including a Bravo Study that says I have severe and significant acid reflux and severe inflammation of my esophagus- am waiting to hear back from Humana. My policy doesn't cover weight loss surgery.

However, since I had the Sleeve down in 2010, I do not qualify for the two other surgery fixes due to my stomach tube.

Did yours go through? I'm ready to take Humana on if they deny me. Although I have gained some weight back, this isn't about weight loss.

Any advice?

Being converted to gastric bypass

by: Stef

Hi, my name is Stef. I had the gastric sleeve surgery in March 2015. I had a weight loss of 90lbs now weighing 169. I have struggled with severe GERD for the last 2 years and found out that I have several esophageal ulcers and erosion. My surgeon has convinced me to convert to gastric bypass.

I am so nervous on what to expect. I did very well with the sleeve other than the reflux. I had significant hair loss the first time around. I’m nervous to lose too much weight and lose more hair. Can anyone share their experience or give me some insight on what to expect?

Lori Sleeve to Bypass I feel your pain.

by: Gret hen

I had a VSG 11/14/16. On 9/17/16, my 50th bday, I weighted 394lbs. I had been living in a nursing home for 6years at that point. In 2015, I started the process of getting ready for my VSG surgery at Ohio State University's Wexner Medical center. I had seen 5 different surgeons and no one would touch me with my BMI being so high. Dr. Bradley Needleman agreed to do my surgery.

I sit here typing this 10 days before my scheduled revision to a RnY. I lost at the highest 123lbs, but after 9 months the yoyo started. Mind you during those first 9 months, I also had 8 trips to the ER and 2 admissions due to "unspecified cardiac pain".

Well in August 2017, I had an EDG and was told all those ER visits had nothing to do with "cardiac pain". My sleeve, according to my Gastro guy looked like ground beef. He couldn't even be sure by visual inspection, that I didn't have stomach cancer, so he had to take 6 biopsies. After the reports came back it was diagnosed as acute gastritis causing severe exacerbation of my GERD, multiple strictures and a Hiatal hernia.

An EDG with BRAVO was scheduled 4 times and screwed up 4 times by a CNP, who lost her job due to incompetence.

Finally, I saw surgeon 3 weeks ago and he told me, "I am sorry my staff has made a mess of this. We are going to do a revision to RnY asap. This should lessen your gastritis and as a result your GERD. I will also take care of the hernia while I am in there. I was hoping we could have gotten by with must the VSG, but without your original issues, I was afraid, we were going to end up here."

Not a comforting speech. Because, I am an up front person. If this was a possibility back in November of 2016, I would have preferred to have been told then.

So, I started the LSD on the 16th. From the 7th of April to the 27th, I have only lost 2.9lbs and it has been up 3 down 2, up 2 down 4 etc. since August of 2017. This revision is a last ditch effort to help my health. I have been living in a nursing home for 8+ years. I will be 52 in September.

I still have a list of 32 diagnoses, but that is 19 less than 2 years ago. I am no longer diabetic, which is high but I have a long hard road ahead.

I have been lobbying for better food here. Healthier would be a huge step.

Nursing homes dietary objective is to keep you full and happy, so you live longer and therefore pay longer. The suggested diet for a regular menu plan is 3200-3700 calories a day. It will more than sustaining and plump up the little old lady/man, increasing their lifespan and keeping them alive longer to stay longer and pay longer. I don't and won't fit I'm that niche. I am the first Bariatric patient they have ever had and it is a constant struggle to get healthy foods.

It took me 5 years to get a piece of fish and chicken breast that was not breaded and deep fried, but I did it. So I will continue to fight for better conditions.

I don't plan on spending the rest of my life here. I have a time line and I am sticking to it. RnY 5/9. PT starts the day after discharge. Up and out of wheelchair to a rolling walker by end of June and keep moving from then on. Plastics in 2020, but somewhere along the way, a right knee replacement, if weight loss doesn't aid in lessening the problems there.

So Lori, I will post again 30 days after revision and give you a heads up. Good luck and God bless.

Getting ready for round 2

by: Crystal

I had my sleeve about ten years ago and lost about 60 pounds, following the death of my husband I dropped another 40 down to 130 (a bit too small). Now I’m 140 and it is a happy weight but severe GERD and esophageal ulcers have made it necessary to have an RNY later this week. I’m terrified!

I am a very unhealthy and poor eater and I’ve had malnutrition problems before and afraid it will get worse and I am terrified of regaining weight after all of this time

Had sleeve in 2017 want to know about bypass surgery.

by: Catherine Custance

After surgery I have lost over 80 lbs but seem to be frozen now in time..really need to lose a lot more. Want to know if my insurance would now pay for bypass??

Weight loss after revision & Test results

by: Becky Kaapuni

Hello,

I have severe heartburn and non of the tests I have are diagnosing it. Did your tests show that you were experiencing acid reflux? Also, how were you able to lose weight after the revision? I am concerned that my stomach will no longer be restricted. Any advice would be great! Thank you!

Just wondering

by: Cori

I am 4 years post op and from the very begining i had problems with my gastric sleeve. I started at almost 500 lbs and have lost down to 263. I feel better health wise, as far as weight loss, but do nothing but throw up everything I eat and drink.

i live on rolaids and have protein and iron and potassium deficiencies and suffer terrible heart burn and acid reflux.

I have been in and out of the ER with gastritis and uti's and low blood pressure episodes to where I faint at times. Been wondering if bypass surgery would help with the acid. When I first had surgery it was a nightmare i was in the hospital for 2 months post op for hemorrhaging and infection and not being able to walk or even eat and not being able to drink at all not even the medicine cups of protein shakes.

I really dont want that to happen again but certainly willing to do whatever it takes to hold down some food and fluids i cant eat a meal of any kind but 10 mins later I'm in the bathroom having it come right back out.

Please help with any info you could offer thank you

Lori, Diagnosed with VSG with twisted stomach as well

by: Stella

Hi Lori,

I had my sleeve done November 2010 and while I've dropped 110lbs, my weight is creeping back up as I have put on 50 lbs. The worse part has been the increased vomiting over the last year which was troublesome enough for me to seek a diagnosis.

I had an UGI and was diagnosed with a twisted stomach as well. He recommended a conversion to RNY but I can't get my head wrapped around doing it. So my GI recommended we try a 3 series balloon dilation to stretch my stomach out. I had the first done earlier this year and it relieved my vomiting for two weeks.

It was great! No pressure in my chest. Its back again so I am going in for the 2nd balloon dilation that uses a larger one. I'm hoping this works so I won't have to face a bypass. The Gerd and another balloon failure may make me reconsider having it. Hope this info helps.

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