According to a study published February 5 in the Journal of the American Medical Association, laparoscopic sleeve gastrectomy does not help GERD symptoms like first thought. The study looked at nearly 39,000 patients found that while traditional gastric bypass surgery did help reduce heartburn and acid reflux; the new procedure (sleeve gastrectomy) was unhelpful in solving these issues with these patients. Approximately 1 in 11 patients actually developed gastroesophageal reflux disease (GERD) after surgery.
What is GERD?
GERD involves the backflow of stomach contents into the esophagus, a tube responsible for carrying food from the mouth to the stomach. Obesity triples the risk in men and obese women are at six times the risk of it. This backwash of stomach acid causes heartburn and acid reflux. Doctors diagnose this when the patient has heartburn at least twice a week.
The condition can be as dangerous as chronic exposure to stomach acid can change the cells that line the esophagus, leading to cancer. For this study, more than 4,800 patients that had surgery from 2007 to 2010 were evaluated.
Commonly physicians recommend laparoscopic fundoplication surgery to overcome GERD. This procedure entails folding the top portion of the stomach over the esophagus’s opening to prevent backflow of the acidic content.
What is Gastric Sleeve?
During the sleeve gastrectomy surgery, surgeons remove a large portion of the stomach and re-shape it into a sleeve or tube. This new shape, however, doesn’t change how food moves to the gut. Typically weight loss is slower than traditional gastric bypass surgery; however, some patients use this as the first step to a full bypass later.
About the Study
The average age of the patients studied was 46, with three-quarters of the group being women. Their average body mass index was 48 before the surgery. 45% of the sleeve gastrectomy group and 50% of the gastric bypass group had GERD.
After surgery, nearly 84% of those with GERD reported they still had symptoms nearly six months or more, and only 16% had their issues resolved. 9% even said their symptoms got worse.
Ultimately, GERD after surgery was linked to more complications. Nearly 15.1% of those with GERD developed post-op complications compared to 10.6% of those that didn’t have the condition. For sleeve gastrectomy patients, it was also linked to failing to lose at least 50% of their body weight in a year.
Many experts believe that gastric sleeve may not be the answer for some patients as the stomach becomes a tube and offers more resistance to food passing through easily. For someone who may have significant acid reflux or GERD, it may not be the best choice and should be explored before scheduling the surgery.
The study’s author and researchers agree that further research is needed to explore the relationship between the two. The researchers suggest that those with preexisting GERD should be evaluated more closely than those who don’t have the affliction. Ultimately, the severity of the disease should be a strong factor in what type of bariatric surgical procedure that a patient is recommended to have. Exploring the existence and severity of this disease will lead to better success and more remission rates for patients in the future.
Anti-Reflux Sleeve Gastrectomy
Gastric sleeve and Nissan Fundoplication can be performed as a single procedure in patients with obesity and GERD to help reflux. This procedure shows great short-term results, however, only 50% satisfactory on a long-term basis.
Don’t be alarmed: Gastric Sleeve still has promising results and benefits