Obese man with heartburn

How to Fix Acid Reflux After Gastric Sleeve Surgery

obese man with heartburn

Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common concern arising after gastric sleeve surgery. This surgical weight loss procedure, also called sleeve gastrectomy, involves reducing the stomach size to promote weight loss by limiting the amount of food consumed. 

While this surgery has numerous benefits for individuals struggling with obesity and related health issues, it can lead to changes in the anatomy of the stomach that may contribute to acid reflux. Managing acid reflux after gastric sleeve surgery is essential to ensure the procedure’s success and maintain overall health and quality of life. 

This post will explore strategies and lifestyle modifications to help individuals address and alleviate acid reflux post-gastric sleeve surgery.

Symptoms of GERD in Gastric Sleeve Patients

Here are common symptoms of GERD that may occur after a gastric sleeve procedure:

  1. Heartburn: This is the most common symptom of GERD. It typically presents as a burning sensation in the chest, often after meals or when lying down. Persistent heartburn can sometimes be severe and may be mistaken for a heart-related issue.
  2. Regurgitation is the sensation of stomach contents, including acid, flowing back into the mouth or throat. It can cause a sour or bitter taste in the mouth.
  3. Difficulty Swallowing: Also known as dysphagia, this symptom may arise if the narrowing of the stomach after gastric sleeve surgery causes food to move more slowly through the digestive tract.
  4. Chest Pain: GERD-related chest pain may be similar to heartburn but can also be mistaken for heart-related pain. It’s important to distinguish between the two, as a medical professional should always evaluate chest pain.
  5. Sore Throat: Repeated throat exposure to stomach acid can cause irritation and lead to a persistent sore throat or hoarseness.
  6. Chronic Cough: A cough that persists for an extended period, especially when it’s worse at night or in the early morning, can be a symptom of GERD. The reflux of stomach contents can irritate the airways and trigger a cough.
  7. Asthma Symptoms: Some individuals with GERD, including those who have had gastric sleeve surgery, may experience exacerbated asthma symptoms or new-onset asthma due to acid reflux irritating the airways.
  8. Laryngitis: Inflammation of the voice box (laryngitis) can result from stomach acid reaching the upper respiratory tract.
lady with GERD

Understanding the Mechanism of Acid Reflux Post-Gastric Sleeve Surgery

Gastric sleeve surgery involves the removal of a significant portion of the stomach, leaving a smaller, banana-shaped stomach pouch. This alteration in stomach anatomy can impact the normal functions of digestion and lead to changes in how stomach contents, including stomach acid, are handled. 

One of the primary factors contributing to acid reflux after gastric sleeve surgery is the reduction in stomach size. With a smaller stomach, there is less space to hold food, and the stomach can become full more quickly. This can cause increased pressure on the lower esophageal sphincter (LES), the muscle that separates the stomach from the esophagus. 

When the pressure on the LES increases, it may become less effective at preventing stomach contents from flowing back into the esophagus, leading to acid reflux.

Dietician meeting with patient

Treatment Options of Heartburn Symptoms After Gastric Bypass Surgery

1. Medication Management

One of the first steps in addressing acid reflux after gastric sleeve surgery is through medication management. Consulting with a healthcare professional, such as a gastroenterologist or the bariatric surgeon who performed the gastric sleeve surgery, is crucial to determine the most appropriate medications to control acid reflux symptoms. Common medications prescribed for acid reflux include proton pump inhibitors (PPIs) and H2 blockers.

2. Dietary Modifications

Making strategic changes to your diet can significantly help alleviate acid reflux symptoms. It’s essential to avoid foods that are known to trigger acid reflux, such as acidic, spicy, or fatty foods. These can irritate the stomach lining and exacerbate reflux. Instead, focus on a balanced diet with lean proteins, whole grains, fruits, and vegetables. Smaller, more frequent meals can help prevent the smaller stomach pouch overload, reducing the pressure on the LES.

3. Hydration Habits

Proper hydration is essential, but adjusting your drinking habits to minimize the risk of acid reflux is important. Drinking large amounts of liquid with meals can increase the pressure on the LES and contribute to reflux. To avoid this, sip fluids between meals rather than during meals. This practice ensures that you stay hydrated without compromising digestion.

4. Elevate Your Head

Elevating the head of your bed can be particularly helpful, especially when dealing with nighttime acid reflux. When you sleep with your upper body slightly elevated, gravity can prevent stomach contents from flowing back into the esophagus. This position can significantly reduce the occurrence and severity of nighttime acid reflux.

5. Lifestyle Changes

Several lifestyle modifications can positively impact acid reflux symptoms after gastric sleeve surgery. Smoking is a known contributor to acid reflux, and quitting smoking can significantly alleviate symptoms. Limiting alcohol and caffeine intake can also help reduce the risk of reflux. Additionally, if you’re overweight, losing weight through 

a healthy diet and regular exercise can alleviate pressure on the stomach and improve reflux symptoms.

6. Stress Management

Stress is often overlooked as a potential contributor to acid reflux. However, stress can exacerbate the symptoms of GERD. Incorporating stress-reducing techniques into your daily routine, such as meditation, yoga, deep breathing exercises, or mindfulness practices, can positively impact your mental well-being and digestive health.

7. Regular Follow-Up

Gastric sleeve surgery has long-term effects on your digestive system and overall health. Follow-up appointments enable your healthcare provider to monitor your health over the years, detect potential issues early, and recommend additional screenings or tests as needed. If GERD symptoms are present, your provider can discuss dietary habits, potential prescription medications, and other treatment options available to help alleviate the problem. 

lady under the covers who can't sleep

What Can Happen if GERD is Left Untreated:

Untreated gastroesophageal reflux disease (GERD) can lead to a range of complications that can affect your quality of life and overall health. It’s essential to manage GERD to prevent these potential issues. Here are some of the complications that can arise if GERD is left untreated:

  1. Esophagitis: Chronic exposure to stomach acid can cause inflammation and damage to the lining of the esophagus, a condition known as esophagitis. This can lead to discomfort, pain, and difficulty swallowing.
  2. Strictures: Repeated inflammation and scarring of the esophagus can lead to the formation of strictures, which are narrowed areas in the esophagus. Strictures can make swallowing even more challenging and may require medical intervention to widen the esophagus.
  3. Barrett’s Esophagus: Chronic acid reflux can sometimes lead to changes in the cells lining the lower esophagus. This condition is known as Barrett’s esophagus and is a risk factor for esophageal cancer.
  4. Esophageal Ulcers: Stomach acid can cause ulcers in the esophagus, leading to pain, bleeding, and potential complications if left untreated.
  5. Respiratory Issues: GERD can trigger or exacerbate respiratory issues, such as asthma or chronic cough, as stomach acid can reach the upper respiratory tract and irritate the airways.
  6. Dental Problems: Stomach acid in the mouth due to regurgitation can lead to dental issues, including enamel erosion, bad breath, and an increased risk of cavities.
  7. Chest Pain: Chronic GERD symptoms, if not properly evaluated, can be mistaken for heart-related chest pain (angina). It’s crucial to differentiate between GERD-related symptoms and cardiac issues.
  8. Sleep Disturbances: Nighttime GERD symptoms can disrupt sleep, leading to poor sleep quality, daytime fatigue, and reduced overall well-being.
  9. Weight Loss and Malnutrition: Severe GERD symptoms, such as difficulty swallowing or chronic vomiting, can result in weight loss and potential nutritional deficiencies.
  10. Esophageal Cancer: Although the risk is relatively low, long-term untreated GERD, especially when combined with other risk factors such as smoking, obesity, or Barrett’s esophagus, can increase the risk of developing esophageal cancer.
pharmacist Michael

Acid reflux after gastric sleeve surgery is a common concern that requires attention and proactive management. The changes in stomach anatomy following the surgery can contribute to developing or exacerbating acid reflux symptoms. By working closely with healthcare professionals, implementing dietary modifications, adjusting hydration habits, elevating the head during sleep, making lifestyle changes, managing stress, and staying committed to regular follow-up appointments, individuals can effectively address acid reflux and enjoy the many benefits of their gastric sleeve surgery, including long-term weight loss and improved health. It’s crucial to remember that each individual’s situation is unique, so personalized advice from a healthcare provider is essential to determine the most appropriate strategies for managing acid reflux post-gastric sleeve surgery.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Retail Pharmacist

Is Pharmacy a Good Career Choice?

Retail Pharmacist

Should you go to pharmacy school to become a
pharmacist? 

I’m going to give you some reasons why it’s a great idea to become a pharmacist.

There are so many things you can do with a pharmacy degree.


A lot of people think of a pharmacist as somebody who works at a Walgreens or CVS

pharmacy behind the counter and hands you prescriptions while giving you advice on how to take
your medications. 

That is one thing that you can do as a pharmacist, and that can be
rewarding, especially if you enjoy people. 

If you like seeing little kids and helping the public, retail pharmacy is a great place to be.

You can work one or two days a week and make as much money as many
people who work five days a week.

 

mom with 3 kids

If you are a mom and you want to spend some time with your kids, pharmacy is a great profession.  There are a lot of companies that will allow you to work when you want to work. 

There are also places that you can work as a pharmacist besides retail pharmacy,  let’s talk about some of those.

Hospital Pharmacy

Hospital pharmacy is different than retail pharmacy. The advantages are you have more clinical input with regard to drug therapy. The doctors ask you a lot more questions and it is more intense. There are specialties you can go into within the hospital as well.

You might want to be an ICU pharmacist or an emergency room pharmacist. You can
specialize in working with mothers and newborns or chemotherapy. There’s a lot of different things that a
hospital pharmacist can do. 

Most hospitals are open 24 hours a day, so there’s a chance that you may have to work evenings and overnight.
That is the downside of hospital pharmacy, but it is the type of hospital pharmacy I really enjoy. 

I’ve worked in hospitals for a large part of my career.

A lot of pharmacy schools are pushing residency right now, especially for hospitals. I can tell you that I just hired a pharmacist that hasn’t even graduated from pharmacy school. It is not true that you cannot get a hospital job without a residency. There may be some cities where it’s more difficult to do, but it’s certainly not impossible. They’ve been advocating for residency for years, but I have personally witnessed many pharmacists getting hired without it. Don’t think you must do a residency to get hired at a hospital.

Pharmacy Management

Every pharmacy needs a manager. You can be the manager of a drug store, a hospital pharmacy, a compounding pharmacy, etc. Pharmacy managers keep the pharmacy staffed, look over the profit and loss statements, figure
out how to be more productive and how to save money.  They manage the staff, do evaluations, and are usually involved in many projects.   Managers often spend a large portion of their days in various meetings.

College Professor

Academics

Pharmacists can work in academics.  You can be a pharmacy instructor. A lot of people like this job because it’s Monday through Friday, nine to five, and the stress probably isn’t as high. You get to teach the new generation of pharmacists how to be successful which can be very rewarding.

Ambulatory Care Pharmacy

Ambulatory care clinics are usually connected to a hospital system. These pharmacists work in a clinic and see patients.  They help them with various types of drug therapy.  Ambulatory care pharmacists specialize in anticoagulation, hypertension, psychiatry, diabetes, HIV, and other chronic illnesses.

Ambulatory care pharmacists usually work Monday through Friday during the day.

Compounding Pharmacy

Compounding pharmacists make drugs that are not available by bigger manufacturers.  They make creams, ointments, suppositories and other dosage forms that are not commercially available.  They may need to make products to remove ingredients that a patient is allergic to.  They may also make medications that are on backorder from the manufacturer.

Nuclear Pharmacy

A lot of people don’t know about nuclear pharmacy. This is what I did for about 12 years of
my career. Nuclear pharmacy is where you make, test, and distribute radioactive drugs for diagnostic
imaging. 

What are the advantages of this type of pharmacy?  You usually get paid more and you don’t deal with the public.  

Disadvantages include being on-call, which I did not like, poor working hours, and radiation exposure. 

Long Term Care

Another type of pharmacy is long-term care. These pharmacies distribute drugs to nursing homes, memory care
units and skilled nursing facilities throughout the area. As a pharmacist, you would double check the
prescriptions that the technicians enter into the computer system, and check the
bubble packs.  You can also consult, which I kind of enjoyed, and that’s where
you go into the nursing home and make sure that they’re doing things the way they’re
supposed to do. Are the medications appropriate for the patient? You make
recommendations based on age, renal function, lab values, etc.

Telepharmacy

 The last type of pharmacy that I want to talk about is telepharmacy. This is where you work from home, sign into a computer and verify orders from multiple hospitals, possibly in multiple states. When I did this, I had
a license in 15 different states, and worked for nine different hospitals simultaneously.  Telepharmacists process orders and dose different drugs based on hospital protocols. You can also work for insurance companies or retail pharmacies as well. So there are opportunities for pharmacists to work from home. The disadvantage of telepharmacy is the pay is less and the hours are less than ideal. If you want to stay home with your children, this could be a good option.

Should you take the plunge and go to pharmacy school? The answer to that question is up to you.  As described in this post, there are many different opportunities available.  The work schedule is flexible depending on the field of pharmacy you choose.  I have always had more than one job ever since I’ve been a pharmacist.  This has allowed me to make a pretty good living. 

Pharmacists help people. It makes you feel good knowing that you’re helping your patients and the healthcare system
in general.  If you’re interested in pharmacy, the one thing that I would strongly recommend is going to a pharmacy and shadowing a pharmacist. When I went to pharmacy school, I had no idea what I was getting into. 

I wanted to be a veterinarian but ended up as a pharmacist.  I am not complaining, pharmacy has been good to me. 

Decide what you want to do and go for it. I think pharmacy is a great career.  

If you have any questions about pharmacy school or if you want to talk to me directly, send me an email at:

 [email protected]

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Compulsive vs Impulsive Behavior, Are They the Same?

What is the main difference between compulsive behavior and impulsivity? I tell my students that compulsive behavior is repeated by the person even though that person is aware that this behavior will not result in the desired goal.

Some Great Bacopa Benefits

What are the benefits of this herb?

Are there side effects?

What can Bacopa do for you?

Bacopa monnieri is a plant that grows in tropical, moist environments in India, Africa, Australia, Europe, and North and South America. This herb has been used for thousands of years in Ayurvedic medicine that originated in India and is one of the oldest medical systems in the world. 

Bacopa is best known for its use as a neural tonic and memory enhancer.  It has been used for centuries by the Hindus in rituals involving new-born babies in the belief that it will open gateways to knowledge.  This herb is also thought to have been used by ancient Vedic scholars to memorize extensive hymns and scriptures.

Besides its use as a nootropic, Bacopa has shown promise in attenuating dementia, Parkinson’s disease, and epilepsy.1

Cognitive Enhancement With Bacopa

Enhancing cognitive function often comes with unwanted side effects.  These can be psychological or the result of toxicity.2

 

3

 

4

 

5

Bacopa contains saponins, which are nootropic phytochemicals that produce only minimal adverse effects when consumed in standard dosages.  These chemicals:

  • Possess Antioxidant activity.6
  • May protect the liver.7
  • Possess neuroprotective activity.8

 

I have a particular interest in cognition because I work on a senior psychiatric unit where a large number of patients have some form of dementia. 

Bacopa helps repair damaged neurons, restores synaptic activity, assists with neuronal synthesis, and improves brain function. 

The primary molecular mechanism is achieved by promoting neuronal communication.  This is accomplished by increasing the growth of nerve endings called dendrites.9

 

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Bacopa has been shown to improve delayed recall memory and Stroop task reaction times.12

Antioxidant Effects of Bacopa

The detrimental effects of free radical cell damage are well known.  This damage is linked to many diseases, including diabetes, heart disease, and certain types of cancer.13

The human body has both enzymatic and non-enzymatic free radical scavenger mechanisms to help cells fight oxidative stress. 

Superoxide dismutase (SOD), catalase (CAT), and glutathione reductase are the first line of defense.  The non-enzyme scavengers are vitamin A,C, and E, coenzyme Q10, glutathione, and selenium. 

When an imbalance occurs, as shown in the figure below, free radical damage can lead to aging and cognitive decline.14

Figure 1.15

Bacopa contains powerful antioxidants.16

An extract of Bacopa monnieri was shown to increase the activity of SOD, CAT, and glutathione peroxidase in the prefrontal cortex, hippocampus, and striatum of rats.17

This antioxidant effect has been shown to reverse memory impairment produced in rats using colchicine by attenuating oxidative damage.  This study suggests there may be potential in using Bacopa in the treatment of Alzheimer’s dementia in the future.18

Bacopa and ADHD

A study published in 2014 found a standardized Bacopa monnieri extract significantly reduced all ADHD symptom scores except those relating to social problems.19

Here are the results obtained from this study:

  • Symptom scores for restlessness decreased in 93% of children.
  • Improvement in self-control occurred in 89% of children.
  • ADHD symptoms were reduced in 85% of children.
  • Learning problems were reduced in 78% of children.
  • Impulsivity was reduced in 67% of children.
  • Psychiatric problems were reduced in 52% of children.

The study concluded that B. monnierei was effective in relieving the symptoms of ADHD and was well tolerated.

Other Medical Uses of Bacopa

There are many other possible medical uses of Bacopa.  Some of these include:

  • Anxiety
  • Epilepsy
  • Depression
  • Anti-inflammatory
  • Analgesic
  • Anti-microbial
  • H-Pylori and ulcers
  • Stimulation of the immune system
  • Adaptogenic
  • Anti-neoplastic

More studies need to be conducted in order to discover the many benefits of this herb.

Side Effects of Bacopa

Adverse effects reported in clinical trials include:20

  • Increased stool frequency (30%)
  • Nausea (18%)
  • Abdominal cramps (16%)

Less common effects include:21

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  • Bloating
  • Decreased appetite
  • Dry mouth
  • Fatigue
  • Flatulence
  • Headache
  • Insomnia
  • Palpitations
  • Vivid dreams
Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Are Rasberry Ketones Safe While Pregnant Or Breastfeeding? Do They Work For Weight Loss? Are There Side Effects?

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

What can I use raspberry ketone for?

Is raspberry ketone safe while pregnant or breastfeeding?

Is a raspberry ketone supplement right for me?

Raspberry ketone is the compound found in the red raspberry responsible for its distinctive odor. This substance is often used as a flavoring agent in the food industry.

 16

Raspberry ketone is a popular weight loss supplement. This substance has also has been used to promote hair growth and improve the elasticity of the skin.

This post will take a closer look at this unique substance and the data to support its use. Raspberry ketone is available at our Sunshine Store in both capsule and liquid form.

Raspberry Ketones for Weight Loss and Obesity

Raspberry ketone helps to regulate adiponectin in the body. Adiponectin is a protein specific to adipocytes (cells that store fat). Adiponectin is thought to affect both insulin resistance and atherosclerosis.

 Raspberry ketone helps to burn fat by breaking it up more efficiently within these specialized cells. 

Higher levels of adiponectin are found in people with healthy weight. As overweight individuals lose weight, adiponectin levels increase.

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After four weeks of supplementation with raspberry ketone, Ushiki et al. were able to show a significant loss of both body weight and body fat. Arteriosclerosis index scores and triglyceride levels were also suppressed.

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The data mentioned above is from three small studies. There are many success stories on the internet for individuals claiming raspberry ketone has helped them lose weight. 

I am currently in the middle of the Whole 30 diet, so am unable to test the product at this time. I plan to try my supplement in both forms to see if it indeed curbs my appetite.

 More research needs to be conducted to determine the optimum dose, potential side effects, and effectiveness of raspberry ketone supplements in helping with weight loss. 

 

Raspberry Ketones for Hair Loss and Skin Rejuvenation

Raspberry ketone may be useful in treating alopecia (hair loss).

A small study was conducted by Harada et al. in 2008. This study had many limitations, including a small sample size (N=10).

After five months of daily treatment with topical 0.01% raspberry ketone cream, 50% of the subjects showed increased hair growth.


This same study also looked at the effects of raspberry ketones on skin elasticity.

The study was performed on ten healthy females. The researchers concluded the topical raspberry ketone increased cheek skin elasticity.

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Raspberry ketone works by promoting the release of insulin growth factor 1 (IGF-1) in the scalp. This helps to create new hair cells and increase hair count.

Raspberry Ketone Use During Pregnancy and Breastfeeding

Although the FDA categorizes raspberry ketone as “Generally Recognized as Safe” when used as a food additive, there is insufficient evidence to determine whether this substance is a safe supplement for weight loss in individuals who are pregnant or breastfeeding. I would suggest not using raspberry ketone if you fit into either of these categories.

Raspberry Ketone Side Effects

More studies need to be conducted to determine the incidence of various side effects that may be caused by raspberry ketone. I have listed a few adverse effects reported by users of this substance below:

  • Increased blood pressure and heart rate.
  • Nausea.
  • feeling jittery.
  • Decreased blood sugar levels.
Michael Brown pictured with Final Thought written

After researching raspberry ketone, I believe this supplement can work for some people.  I would prefer to see more research on its effect on weight loss.  I do not think this supplement is harmful, but would definitely not recommend it to a woman who was pregnant or breastfeeding. I feel the risk outweigh the benefit in this circumstance. 


Overall I have been impressed with the positive information I have learned while researching my supplements. I plan to keep the raspberry ketone in my store as I believe it may benefit some of my readers. 

My product also contains African Mango, which has positive effects on obesity and diabetes.


I would love to hear feedback from anyone who has used this product. I may even add your story to this post!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.