Obesity and acid reflux: does gastric bypass surgery help to relieve reflux?

An image to illustrate acid reflux and whether this can be relieved in people with obesity by having gastric band surgery
© iStock/nebari

A new study has assessed whether gastric bypass surgery can help to relieve acid reflux in patients with severe obesity.

The authors note that:”Physicians and patients should be aware of the limited effect of gastric bypass on reflux in patients with severe obesity, particularly in those with risk factors for post operative reflux.”

Obesity and acid reflux

Obesity is linked to experiencing heartburn and other symptoms of acid reflux. While previous research has shown that having gastric bypass surgery helps to relieve the symptoms of acid reflux in obese patients in the short term.

However, the new study has found that these benefits are often not long-term.

The results

The Alimentary Pharmacology & Therapeutics study assessed 2454 patients, mostly women. Although the acid reflux symptoms improved in the short term following the gastric bypass surgery for the majority of patients who were also taking acid reflux medicines, in almost half all of all patients these symptoms returned within two years.

Symptoms were most likely to return in:

  • Women;
  • Older individuals; and
  • Other medical problems.

The paper says: “Although the treatment effect observed in this study was immediate and durable, it was insufficient in about half of all patients.”

“The results should mainly be generalised to patients with reflux symptoms. Yet, compared to other bariatric surgical methods, gastric bypass is likely the most efficient in the treatment of reflux, as it leads to superior weight loss and preservation of the lower oesophageal sphincter, although there is paucity of studies with follow‐up longer than 1 year. ”

It concludes:”This large and population‐based cohort study with long and complete follow‐up indicates that gastric bypass is an effective and long‐lasting treatment of GERD in only approximately 50% of patients with severe obesity.  This is a lower success rate than in previous studies, indicating that the treatment effect may have been overstated. Physicians and patients should be aware of the limited effect of gastric bypass on reflux in patients with severe obesity, particularly in those with risk factors for postoperative reflux, that is, high dose of preoperative anti‐reflux medication, older age, female sex and comorbidity.”

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