With the increasing incidence of obesity, more people are undergoing bariatric surgery to lose weight. Laparoscopic adjustable gastric banding, a procedure introduced to the U.S. in 2001, is a common bariatric surgery. Like any surgery, gastric banding can be associated with complications. Acid reflux is a relatively minor but common problem after gastric banding. A thorough evaluation before surgery and appropriate lifestyle changes after your procedure can reduce the frequency and severity of acid reflux symptoms.
Bariatric procedures are generally classified as either malabsorptive or restrictive, depending on whether they primarily interfere with absorption of calories or restrict the volume of food you can eat. In reality, many bariatric surgeries have components of both classifications. Gastric banding is primarily a restrictive procedure. A constricting band around the upper portion of your stomach creates a small pouch that limits the amount you can eat comfortably to only a few spoonfuls at a time. Because gastric banding reduces the effective size of your stomach and delays the passage of food and fluids to your intestine, acid reflux -- a condition in which the stomach contents move backward into the esophagus -- may occur under certain circumstances.
The principal aim of gastric banding is to reduce how much you eat. Just as overfilling a normal stomach increases your risk for acid reflux, so does overfilling the small pouch created during the gastric banding procedure. Vomiting and acid reflux are common following gastric band placement, according to a 2011 review published in the “Biomedical Imaging and Intervention Journal.” Once you adjust to your new dietary restrictions -- which are necessary for successful weight loss -- reflux usually subsides.
The placement of a constrictive band around your upper stomach may challenge the protective mechanisms that prevent stomach contents from flowing back into your lower esophagus. Nevertheless, those who stick to dietary restrictions and have a normal barrier between their stomach and lower esophagus typically fare well after gastric banding. In contrast, people with preexisting acid reflux or a hiatus hernia -- a portion of the stomach protruding into the chest cavity -- may find their reflux worsening after gastric banding. According to an article in the August 2010 issue of the “World Journal of Gastroenterology,” some bariatric surgeons recommend against performing gastric banding in people with preexisting acid reflux or hiatus hernias.
While gastric banding may temporarily increase your risk for acid reflux, obesity itself can contribute to acid reflux. In people who are morbidly obese and suffer from reflux, bariatric surgery often relieves acid reflux symptoms due to its weight-reducing effects. If acid reflux is a significant problem before bariatric surgery, gastric bypass may be a better option than gastric banding, as it appears to be more effective for reducing reflux. Gastric bypass has even been used to treat gastroesophageal reflux disease in people who are not severely obese but have not experienced symptom relief with traditional antireflux surgery. Before proceeding with gastric banding, review the risks and benefits of this procedure and discuss your options with your surgeon.
- The New England Journal of Medicine: Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects
- Journal of the American College of Surgeons: Laparoscopic Adjustable Gastric Banding: 1,014 Consecutive Cases
- Radiology: Adjustable Laparoscopic Gastric Banding in Patients With Morbid Obesity: Radiographic Management, Results and Postoperative Complications
- Biomedical Imaging and Intervention Journal: The Surgical Management of Obesity With Emphasis on Postoperative Imaging
- World Journal of Gastroenterology: Gastroesophageal Reflux Disease and Severe Obesity: Fundoplication or Bariatric Surgery?