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Acid Reflux, GERD, Obesity and Bariatric Surgery

Acid Reflux, GERD, Obesity and Bariatric Surgery

Heart burn and acid reflux affects many people irrespective of age. While people use the terms Acid reflux and Heartburn interchangeably, they do not mean the same thing. Heart burn is not a disease; it is a symptom of acid reflux and GERD; which is basically chronic acid reflux.

The term heartburn is misleading in that the pain doesn’t even originate from the heart. Heartburn originates in the esophagus and is felt as a mild or severe pain in the chest. It occurs when the acid in the digestive system; penetrates the thin lining of the esophagus and causes a burning pain or sensation in your chest.

Heart burn is usually felt after eating certain meals and may be made worse by lying down or bending. Mild heartburn is quite common and can be managed by use of antacids. However, if you experience mild or chronic heartburn frequently, you may be suffering from acid reflux and you may need to have it checked out by a doctor.

Acid reflux on the other hand is a disease which occurs when the lower esophageal splinter (a small circular muscle that connects the esophagus and the stomach commonly known as LES) weakens. This muscle is primarily responsible for tightening the esophagus and preventing food from moving backward once it enters the stomach.

If this muscle is weakened, food and acids from the stomach will move back to the esophagus hence causing the burning sensation also commonly referred to as heartburn.

Other symptoms of Acid reflux include; a bitter taste in the throat, coughing, sour taste in the mouth, sore throat and a mild or sharp burning pain or pressure that may be felt behind the breastbone.



GERD (Gastro-esophageal Reflux Disease)

While acid reflux is common, manageable and rarely serious, GERD is a chronic severe form of acid reflux that cannot be managed by over the counter antacids and medications. It is usually diagnosed when once experiences acids reflux more than twice or thrice a week or when the symptoms of acid reflux irritate the esophagus causing inflammation.

When diagnosing GERD, doctors assess long-term habits of a patient as well as their anatomy.

Common symptoms of GERD include chronic heartburn, chest pains, severe and persistent dry coughs, constant feeling of food moving back up the mouth from the stomach, asthma and bad breath just to name a few.


What Causes GERD?

Some of the causes of GERD may include some forms of medication, pregnancy, hernia, alcohol, long-term smoking habits and overweight or obesity. This condition can be said to be mild or severe depending on the level of the dysfunction of the LES muscle and the amount as well as the type and frequency of the acid moving back up the esophagus from the stomach. The neutralizing effects of saliva can lessen the severity of GERD.



Why is Acid Reflux More Common in Obese People?

Research studies have been conducted to determine the relationship between GERD and obesity. This is because it was found that a majority of overweight and obese patients also suffered from heartburn, acid reflux and GERD.

According to a Scandinavian study on the link between GERD and obesity carried out in 2003, it was found that overweight and obese women were up to more than six times more likely to develop GERD than people considered to be of normal or average weight.

The frequency was higher especially in overweight and obese women before menopause. Overweight and obese women who were past menopause were found to be up to more than 4 times likely to have GERD than those who were considered to be of normal weight.

The study also showed that moderately and severely obese women who had had hormone treatment were up to 16 times more predisposed to develop GERD; and those who had specifically taken estrogen therapy were up to more than 33 times more at risk of developing GERD compared to other women of average or normal weight.

Thus; the hormone estrogen was strongly found to be a specific factor that may predispose overweight and obese women to develop GERD. Researchers speculate that the hormone stimulates overproduction of nitrous oxide; which relaxes and weakens the LES muscle.

Men who had a BMI of more than 35 (considered as severe obesity) were found to be up to three times more likely to develop acid reflux symptoms compared to other men with normal or average weight.

The study linked GERD to BMI and obesity was found to be a major risk factor to developing GERD.



Does Gastric Bariatric Surgery Lessen Acid Reflux and GERD?

Moderately and severely obese patients may opt for bariatric surgery as a treatment option for their obesity and to reverse obesity related complications like Type 2 diabetes and high blood pressure.  Some obese patients report a significant improvement in their GERD and acid reflux symptoms along with the improvement of other obesity related co morbidities after their bariatric surgery.

In fact, studies have continued to show that weight-loss surgery done as a treatment for obesity was proving to be a more effective treatment option for GERD compared to surgeries which were specifically targeted at treating GERD.

The gastric bypass surgery was found to be especially effective in controlling and even eliminating GERD in patients obese patients regardless of whether they had previously undergone a GERD targeted surgery or not.

This is definitely great news to obese patients who opt for the gastric bypass surgery as a treatment option for their obesity.



Gastric Sleeve Surgery May Worsen Acid Reflux or GERD

While the gastric bypass surgery has proven to be very effective in controlling and even eliminating GERD and acid reflux symptoms, studies have also shown that the gastric sleeve surgery on the other hand could worsen or actually cause reflux or GERD.

Severely obese patients who also suffer from GERD and are considering bariatric surgery are advised to consider other weight loss surgical procedures and avoid the gastric sleeve surgery.

The main reason why patients who opt for gastric sleeve surgery experience acid reflux as a side effect for the first few months after surgery is simple; the procedure involves a drastic shrinking of the stomach capacity by up to 90 percent.

As a result, the remaining reduced stomach reacts by overproducing acid in order to compensate and the size of the stomach makes it hard for the acid to stay confined in the stomach.

This problem however diminishes during the months after the surgery as the body adapts to the new shape and size of the stomach. This is because the stomach will stop producing excess acid and the patient will also be losing weight.



Are You Considering Bariatric Surgery?

For more information on GERD, obesity and the different types of bariatric procedures in Beirut, Lebanon, contact us at Advanced BMI.

Feel free to ask any questions.

Author Info

Pamela Safi