Gastroesophageal Reflux after Bariatric Surgery

By Valerie J. Halpin, MD

 

Gastroesophageal Reflux Disease is a digestive disorder that occurs when a muscle at the end of your esophagus does not close properly, which allows stomach juices, or food and fluids back from the stomach. This backwash can irritate the lining of your esophagus. Research shows acid reflux affects 60 million people at least once a month. But, the bariatric patient, in particular, may be very susceptible to acid reflux symptoms after surgery. Here’s is why.

 

Once you have had bariatric surgery, there may be anatomical issues that can contribute to reflux symptoms. You may develop a hiatal hernia (a hernia in your diaphragm where the esophagus travels from the chest to the belly) after any type of bariatric procedure as your anatomy changes from the weight loss. If you have a gastric band, your band may be too tight, or you may get irritation of the lining of your esophagus from pills sitting there too long.

 

There are a number of other factors that may contribute to reflux symptoms. Food and drink are often part of the problem. Chocolate, caffeine, and alcohol are common culprits that increase reflux symptoms. Other food types that may increase acid reflux are tomato and citrus based items. Eating behaviors also contribute to reflux. Eating quickly and not chewing well, may put food into your stomach faster than it can empty so the food backs up into your esophagus. Eating too much at one time may have the same effect. Eating large meals may also increase the pressure in your belly and therefore increase the likelihood that you will reflux stomach or pouch contents back up into your chest.

 

What should you do if you are having reflux symptoms? Contact your bariatric provider and work on developing a plan that is appropriate for you and your situation. Keep a food diary to see if there are any foods that are making your symptoms worse. Make sure to take enough time between taking all your medications so that your pills can go down. Get back to basics with your eating habits! Make sure you are eating small bites and waiting long enough for the food to get moving through your pouch or stomach. Once you’ve had a chance to follow up with your provider, you can decide together whether any testing or other procedures are needed.