"Some patients-about one-third-remained on antisecretory medication even after the conversion to fully manage their GERD symptoms," says Burch. Overall, patients experienced markedly reduced GERD symptoms, significant improvement in HRQL severity scores and even some additional weight loss after conversion-with a few caveats. They obtained symptom severity scores using the GERD HRQL questionnaire to determine symptom severity before and after conversion. To gauge the success of conversion to RYGB to treat GERD, the team reviewed the cases of 54 patients, 41 of whom underwent conversion for indication including GERD. This separates the esophagus from the part of the stomach that makes most of the acid and also prevents bile from the small intestine from coming back up into the esophagus. ![]() When converting LSG to RYGB, surgeons bypass the remaining stomach by creating a detour around the bottom part through the small intestine and using the top third of the sleeve as a stomach pouch. "It’s hard to know exactly what’s causing the problem-it could be someone’s esophagus being overly challenged by the sleeve or a weakening of the esophageal valve allowing stomach contents to go backward and up into the esophagus." ![]() ![]() "It took some time to figure out that the sleeve gastrectomy may be causing or worsening reflux in a small percentage of patients," says Miguel Burch, MD, chief of Minimally Invasive and GI Surgery. The popularity of LSG has been driven by its simplicity and the apparent absence of negative side effects.
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