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New Weight-Loss Surgery May Not Ease Heartburn

Study finds sleeve gastrectomy often doesn't relieve acid reflux, and sometimes makes it worse

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The average age of patients in the study was 46. Nearly three-quarters of patients in both groups were women, and the average body mass index (BMI) for both groups was 48 before surgery, suggesting that each group had similar amounts of weight to lose.

Before surgery, 45 percent of the sleeve gastrectomy group and 50 percent of the gastric bypass group had GERD.

After surgery, the picture changed.

Among those who had sleeve gastrectomies, nearly 84 percent of GERD sufferers said they still had symptoms six months or more after their procedures, while 16 percent said their symptoms had resolved. Nine percent said their symptoms got worse, the study found.

After gastric bypass, however, 63 percent of GERD sufferers saw complete resolution of their symptoms at least six months after surgery. GERD symptoms stabilized in 18 percent of patients, while 2.2 percent saw their symptoms worsen.

What's more, within the group that went into surgery untroubled by heartburn, 9 percent developed GERD after their sleeve gastrectomy.

GERD after weight-loss surgery was linked to having more complications overall. And for sleeve gastrectomy patients, it was also linked to the failure to lose at least 50 percent of body weight over the next year.

"Bariatric surgery isn't one-operation-fits-all. It really needs to be tailored to the patient," said study author Dr. Matthew Martin, a surgeon at Madigan Army Medical Center in Tacoma, Wash.

Martin said shape probably accounted for the differences in GERD symptoms after surgery. With the sleeve, the stomach becomes a tube, which offers more resistance to food passing through than the rounder pouch created by the bypass.

"Somebody who has significant reflux symptoms, or GERD, a sleeve may not be the best option for them, and it's certainly something that needs to be discussed before surgery," he said.

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