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Reflux after Bariatric Surgery

Patients who have had a bariatric surgery may continue to have reflux or may develop reflux despite weight loss. Treating these symptoms can be difficult given the changes to the anatomy that occurred with the weight loss surgery. The majority of bariatric procedures today consist of a sleeve gastrectomy, and a gastric bypass.

It is very important to make sure your surgeon has experience with LINX. Dr Bell is advocating for patients and feels these surgeries are best done by surgeons with expertise in reflux, and not just bariatric surgery.

LINX as an option after Sleeve gastrectomy

It is estimated that 10% to 20% of sleeve gastrectomy patients will develop reflux. This is in part due to the new tube/smaller stomach having a higher pressure than before surgery, as well as changes near the valve between the stomach and esophagus. Until recently, the only way to treat reflux in these patients was to surgically change the sleeve to a Roux-en-y (gastric bypass). This is not appealing for many patients as they initially chose the sleeve over the gastric bypass.
In select patients the LINX reflux management system has enabled patients to keep the sleeve gastrectomy while having their reflux controlled. The results of a few small studies are promising when careful, comprehensive evaluation to select the appropriate patient has been performed.

LINX as an option after Roux-en-y (gastric bypass)

Reflux can occur after a gastric bypass, even though the stomach is now very small. Diagnosis can be difficult as some patients also do not produce much acid, and usually present with LPR (link to LPR page) symptoms and not typical reflux symptoms (heartburn or regurgitation).
Given the anatomy changes with the gastric bypass, until recently, the only option for these patients has been revision of the gastric bypass, with significant risks and often unsatisfactory results.

An alternative, again in appropriately selected patients, has been the LINX reflux management system. The results of a few small studies indicate good reflux control in most patients, without the risks of having to alter the anatomy.

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