As discussed earlier, patients who have significant heartburn (GERD) should strongly consider a gastric bypass, rather than a Sleeve Gastrectomy. While most of us experience some heartburn from time to time, there is a small group of patients who experience significant, daily heartburn that often interferes with sleep or your ability to enjoy a meal with friends. If heartburn is a daily part of your life, then a gastric bypass will typically eliminate these symptoms, while the heartburn reducing effects of a Sleeve Gastrectomy are more variable. Some patients experience improvement of their symptoms, many stay the same and others report worse symptoms after surgery.
While our early scientific literature reported a significant increase in heartburn after a sleeve gastrectomy, I have not found this in my practice. Over the last few years, most surgeons have increased the diameter of the sleeve in the mid portion of the stomach which increases the safety profile of the procedure as well as reducing the rate of heartburn after surgery. Additionally, we typically repair any hiatal hernias that we identify at the same time we perform the Sleeve Gastrectomy. Hiatal hernias cause the stomach to slip up into your chest and often reduce the effectiveness of the valve that prevents the acid in your stomach from refluxing back up into your esophagus, burning the lining. When we surgically restore the position of the valve, back into the abdomen where it belongs (it typically only take 15 minutes to do this), we restore the function of the valve and often times will improve heartburn symptoms. Those who are considering a sleeve gastrectomy who suffer from heartburn may still be candidates for the procedure, if they have a hiatal hernia. Since the hiatal hernia will be fixed at the time of surgery, it is unlikely that you will experience any worsening of your symptoms afterward.