Category Archives: GERD
Obesity is a leading cause of GERD and related issues, like hiatal hernias. Studies have shown that increased body mass index and excess eating can stress the esophagus. Certain bariatric surgeries can correct GERD, but others can bring it about or worsen existing cases.
The Roux-en-Y gastric bypass procedure is the gold standard in eliminating severe and uncontrolled GERD. This is particularly true when comparing it to the gastric band or the gastric sleeve, both of which may cause a small number of patients to experience new or worsened acid reflux. However, it is worth noting that the likelihood of new or worsened GERD after the gastric sleeve is significantly reduced when a hiatal hernia, if present, is identified and correct during surgery.
Statistics estimate that GERD affects about 20 percent of the population in the United States. To manage this condition, many people look to proton-pump inhibitor, or PPI therapy. PPI therapy is a medication, usually over the counter, that reduces the amount of stomach acid production. It is nearly impossible to completely inhibit the production of stomach acid.
You probably don’t know anyone that hasn’t experienced some sort of reflux. This may be caused by a large meal, particularly spicy food, strenuous activity shortly after a meal or even sleep shortly after eating. It happens to all of us once in a while. However, when simple acid reflux becomes chronic, this is when we diagnose it as gastroesophageal reflux disease or GERD.
GERD, on the surface, seems like a relatively innocuous problem that simply causes some discomfort after meals and could be managed with antacids or over the counter Proton Pump Inhibitors (PPIs). However, the problems that come with GERD run much deeper, especially if left untreated or undertreated.
When a patient comes in for a bariatric consultation wanting the gastric sleeve, we determine if they are currently suffering from moderate to severe acid reflux. This is because new or worsened acid reflux can be a side effect of the gastric sleeve procedure. While it may seem counterintuitive, after all bariatric surgery is supposed to eliminate the most common conditions associated with obesity, how the gastric sleeve changes the gastrointestinal anatomy is somewhat different from other bariatric procedures.
Zantac is one of the most commonly prescribed medications for gastroesophageal reflux disease/GERD or chronic acid reflux. While most patients experiencing occasional reflux can do quite well with antacids, like Tums, once acid reflux turns chronic, it becomes more difficult to manage and requires medical intervention. Typically, patients were put on one of two medications – both of which are available over the counter:
- H2 antagonists that block the histamine receptors in the stomach to reduce the amount of acid produced. Common brand names are Zantac (ranitidine) and Pepcid
- Proton Pump Inhibitors (PPIs) like omeprazole also block the production of acid in the stomach – brand names of omeprazole are Prilosec and Zegerid
Both options can be effective for many patients as a first line of defense against reflux.
Gastroesophageal reflux disease, more commonly known by its abbreviation GERD, is an all too common condition. Caused by dysfunction of the Lower Esophageal Sphincter (LES), which controls flow into the top of the stomach from the esophagus, chronic acid reflux can lead to frequent discomfort and long-term damage to the upper GI system. GERD can be difficult to manage with several contributing factors like diet, weight, age, and lifestyle.
Patients often start with lifestyle modifications and oral medication like antacids and Proton Pump Inhibitors (PPIs). These, however, do not treat the dysfunction, only attempt to mitigate the symptoms of the LES failure. Further long-term PPI use may be problematic Surgical treatment is the only true corrective option for GERD. Please read below as we discuss the differences and benefits of the two reflux surgery options.