In Part One, we outlined the nature of the beast. In Part Two, we dealt with ways of cooking it. Now, in this part, we will clean up the remains. Sorry to our Gujju (and other vegan) friends for this analogy!
If you have had bariatric surgery and are now having reflux, what now?
(Are you worried about your reflux? Pic source: here)
We need to see what procedure you had. If you had a Band, tough luck! Because, as we mentioned before, the Band does cause reflux and also esophageal dilatation. Now, many surgeons will quickly accuse me of bias here. To which I plead guilty. I have always maintained that the Band is not exactly my favorite operation. While I maintain that it causes reflux in a lot of patients, there are conflicting reports worldwide.
For example, in Dixon’s study, they have found fantastic results after the Lap Band in terms of reflux symptoms and otherwise, too. Ten years later, the Australians reported excellent results in this paper.
(your favorite antacid may help. Pic: here)
After sleeve gastrectomy, reflux is temporary but may be distressing. If you have this problem, here is a list of what to do:
* Chew your food slowly or drink your liquids slowly.
*Avoid processed carbs
*Stay away from coffee, alcohol and tea
*Stop smoking, really stop it, will you?!
* Walk around after dinner
* Take an hour or two (or more) to sleep after dinner
* Keep the head end of the bed elevated
* Take PPIs as prescribed. PPIs are drugs that banish acid secretion.
* For short term burning sensation, drink little cold water and have some preparation like Mucaine gel or Xylocaine viscous (local anesthetic).
* Contact the bariatric team for further advice.
After sleeve, reflux may be distressing and persistent in a small subset of patients. As this recent paper says, there may be an association between a wider proximal stomach tube and a narrower distal tube. This means that the upper part of the stomach tube is wider than the lower part. However, this is not related to the size of the bougie (the rod like thingie that is used as a sizer for the tube prior to stapling). Whether 3 cm or 6 cm of the lower part of the stomach (the antrum) is left behind has no relationship to the severity of reflux. Most of these patients also respond well to medical treatment.
Well, that should wrap up the subject pretty much for you! Please get in touch with us if you need more information.
[...] Part Three, we will examine the rest of the reflux story. Categories: Co-morbidities, Complications, Diet, [...]