If you’ve heard that gastric sleeve causes heartburn, you’re not wrong. But it doesn’t have to.
TL;DR: Acid reflux is one of the most common complaints after traditional gastric sleeve surgery. My enhanced technique significantly reduces this risk by addressing the anatomical factors that cause it. You shouldn’t have to trade one problem for another.
- Traditional gastric sleeve can increase acid reflux in some patients
- The issue is related to how the stomach is shaped and how pressure changes after surgery
- My enhanced technique minimizes these factors
- Most of my patients don’t develop new reflux, and many see existing symptoms improve
The Question I Get Asked More Than Almost Any Other
“Will I get acid reflux after surgery?”
If you’ve done any research on gastric sleeve, you’ve probably seen this concern pop up in forums, Facebook groups, and comment sections. People sharing stories about heartburn that started after their procedure. Warnings about needing daily medication. Some even talking about revision surgery to fix the problem.
It’s enough to make you wonder if the surgery is worth it.
So let me be straight with you: yes, traditional gastric sleeve surgery can cause or worsen acid reflux. The research confirms it. Somewhere between 20 to 30 percent of patients develop new reflux symptoms after a standard sleeve procedure.
But here’s what those forum posts don’t tell you: it doesn’t have to be this way.
Why Traditional Gastric Sleeve Can Cause Reflux
To understand the solution, you need to understand the problem.
During a gastric sleeve procedure, we remove a large portion of the stomach, leaving a narrow tube. This changes a few things:
Increased pressure. Your new stomach is smaller and tighter. When you eat, pressure builds up faster than it did before. That pressure can push stomach acid upward into the esophagus.
Changes to the lower esophageal sphincter. This is the valve between your esophagus and stomach. The reshaping of the stomach can affect how well this valve functions, making it easier for acid to escape.
Altered anatomy. Depending on how the sleeve is created, the angle where the esophagus meets the stomach can change. Some techniques inadvertently create a shape that promotes reflux rather than preventing it.
Reduced stomach capacity. With less room for food and acid to sit, there’s simply less buffer space before things start moving in the wrong direction.
None of this is the surgeon’s “fault” in the traditional sense. It’s a consequence of the anatomy. But that doesn’t mean we can’t do anything about it.
What I Do Differently
My enhanced gastric sleeve technique specifically addresses the factors that contribute to post-operative reflux. This isn’t one single change. It’s a combination of refinements that work together.
Careful attention to the angle of His. This is the angle where your esophagus connects to your stomach. Preserving and optimizing this angle helps maintain the natural anti-reflux barrier your body already has. Some surgical techniques disrupt this angle. Mine protects it.
Appropriate sleeve size. There’s a trend toward making sleeves as small as possible for maximum weight loss. But an overly tight sleeve increases intragastric pressure, which promotes reflux. I create a sleeve that’s effective for weight loss without being so restrictive that it causes problems.
Proper bougie positioning. The bougie is the tube we use to size the sleeve during surgery. Where it’s positioned and how the stapling is done around it affects the final shape. Small differences in technique here make a significant difference in reflux outcomes.
Avoiding excessive tension. How the tissue is handled during surgery matters. Excessive tension on the stomach can distort the anatomy in ways that promote reflux. Gentle, precise technique preserves natural function.
What the Research Shows
I want to be careful here because I’m not going to throw out statistics that make promises I can’t keep. Every patient is different, and some people are simply more prone to reflux than others, regardless of surgical technique.
What I can tell you is this: my patients experience significantly lower rates of new-onset reflux compared to published averages for traditional gastric sleeve. And patients who come to me with existing mild reflux often see improvement after surgery, not worsening.
This isn’t magic. It’s attention to detail.
But What If I Already Have Reflux?
This is where the conversation gets more nuanced.
If you currently have severe acid reflux or GERD (gastroesophageal reflux disease), we need to talk about it during your consultation. In some cases, gastric sleeve may not be the best option for you, and gastric bypass might be a better choice because it actually reduces reflux rather than potentially increasing it.
However, if your reflux is mild or occasional, the enhanced technique often works well. Many of my patients with mild pre-existing reflux find that losing weight actually improves their symptoms overall, and the careful surgical technique prevents new problems from developing.
The key is being honest with me about your symptoms so we can make the right decision together.
A Patient Story
I had a patient last year who almost didn’t pursue surgery because of reflux concerns. She’d read all the horror stories. Her sister had a sleeve done elsewhere and developed terrible heartburn that required daily medication.
She was terrified the same thing would happen to her.
We talked through everything. I explained my technique and why I believed her outcome would be different. She decided to move forward.
At her three-month follow-up, I asked about reflux. She looked at me like I’d asked a strange question. “I don’t have any,” she said. “Was I supposed to?”
Not every patient has that experience. But most do.
What You Should Ask Any Surgeon
If you’re comparing surgeons (and you should be), here are reflux-specific questions worth asking:
- What is your rate of post-operative reflux in sleeve patients?
- Do you modify your technique to reduce reflux risk?
- What do you do if a patient develops reflux after surgery?
- Would you recommend bypass instead of sleeve for someone with my history?
A surgeon who takes reflux seriously will have clear answers. One who dismisses the concern or doesn’t track their outcomes might not be the right fit.
The Bottom Line
You’re considering gastric sleeve surgery to improve your health and quality of life. The last thing you want is to solve one problem while creating another.
Acid reflux after gastric sleeve isn’t inevitable. It’s a risk that can be significantly reduced with the right technique. That’s exactly what my enhanced approach is designed to do.
You shouldn’t have to choose between weight loss and comfort. With proper surgical planning, you can have both.
Key Takeaways
- Traditional gastric sleeve increases reflux risk in 20 to 30 percent of patients
- The enhanced technique addresses the anatomical factors that cause this
- Sleeve size, angle preservation, and surgical precision all matter
- If you have severe existing reflux, bypass might be a better option
- Always ask your surgeon about their approach to reflux prevention
Your Next Step
If reflux concerns have been holding you back from considering gastric sleeve surgery, let’s talk about your specific situation. I’ll be honest with you about whether the sleeve is right for you, or whether another approach might be better.
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