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Heartburn/GERD Health Center

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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For the study, researchers reviewed the cases of patients who had weight-loss surgery between 2007 and 2010. More than 4,800 patients had sleeve gastrectomies over that period, while nearly 34,000 had gastric bypass procedures.

In a gastric bypass, surgeons make a pouch at the top of the stomach that holds about a cup of food. That pouch is then attached directly to the middle portion of the small intestine, rerouting food past the first section of the gut.

In a sleeve gastrectomy, surgeons remove more than 85 percent of the stomach and shape the remainder into a sleeve or tube, but they don't alter how the food travels through the gut. Weight loss with sleeve gastrectomy is generally slower than gastric bypass, and for some patients, this procedure is the first step before a full bypass.

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.

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