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.

Somatic Mindfulness Exercises to Reduce Stress and Anxiety

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.

Can somatic mindfulness exercises help me?

Are they hard to learn?

What are the benefits?

 

Mindfulness has become a popular subject for therapists as well as those seeking self-help ideas to treat anxiety disorders and decrease stress and frustration of daily living.  The COVID-19 outbreak has increased interest even more. 

Mindfulness is the ability to be present in the moment without judgement.  Paying attention to the simple things that we often take for granted.  It is an amazingly simple idea that can really pay off. 

In this post, I am going to explain a few somatic mindfulness exercises you can do to help control anxiety and improve mental health.  These are simple to do and, as with most everything else, practice makes perfect.  If you work on these regularly, you will find them to be very useful.

A Scan of Your Body – C. A. L. M.

This is something I practice often and I find it to be very beneficial for those times when I feel irritated or overwhelmed.  This works best in a quiet place with minimal distractions.  C.A.L.M. helps you remember the large zones of the body to focus on.

Before beginning, get comfortable in any position that suits you at the time.  If possible, lay down.  I find this to be most relaxing but understand it isn’t always convenient.  Close your eyes and take a few slow deep breaths.

Chest:  The first region of the body to concentrate on is your chest.  Pay close attention to your breathing.  Notice how your chest rises as you breathe in and falls as you exhale. 

Are you breathing fast or slow? 

Attempt to regulate the speed of your breathing.  Keep it slow and steady.  As you regulate your breath, your mind and body are also under your control.  You begin to relax.  Imagine your stress and anxiety leaving your body with every exhaled breath.

After a few breaths, take a deep breath and tighten all muscles in your chest.  Hold this for three seconds concentrating on how it feels to be tense.  Finally, allow all your muscles to relax and notice the tension leaving your body with each breath.  Continue to breathe slowly and evenly as you allow your body to fully relax.

Arms:  Focus on your arms.  Using your mind, scan each arm from your shoulders all the way down to each fingertip. 

How do your arms feel? 

Are they tense, relaxed, warm, cold? 

Spend a little time concentrating on just your arms.  If you feel any tension, attempt to relax. 

After a couple of minutes, squeeze each fist and flex all the muscles in each arm tightly.  Finally, release the tension in your arms and relax each hand.  Take a few breaths and notice the feeling of calmness.  Let your body relax as you slowly breathe in and out.

Legs:  Next, focus your mind on your legs from your hips all the way down to your toes.

  How do they feel? 

Are they weak, shaky, warm or cold? 

Are your legs telling you anything about your level of stress or anxiety? 

Begin to squeeze your muscles starting at your feet and extending up to your hips.  Hold this tension for a few seconds and then release. 

Notice how you feel when the tension is released. As you breathe, imagine all the tension from each leg and foot leaving your body.

Mouth:  The last area to focus on is your mouth and jaw.  Many of us tense muscles around our mouth when we are anxious without realizing it. 

What expression is your mouth communicating? 

Is this a result of stress or anxiety? 

As before, clench the muscles around your mouth and jaw for a few seconds and pay close attention to the feeling.  Relax your muscles and with your eyes still closed, smile. 

Enjoy the feeling of relaxation as your breathing helps to remove stress from your body.

  Continue to breathe is this relaxed state thinking about the areas where you noticed evidence of stress and anxiety or tension.  As you breathe, imagine the tension leaving your body with each breath. 

This exercise can be a life-changing skill once developed.  With practice, you will be able to close your eyes and imagine the stress and tension leaving your body just by breathing.

  You can train yourself to identify tension in different areas of your body and remove it using your mind. 

Grounding Exercises

Heel drops:  In this exercise you will start by standing.  Slowly lift up your heels so you are standing on your toes.  Return to your standing position.  Do this repeatedly in a slow, rhythmic pattern.  Pay attention to how your hips and lower back feel while doing this exercise.  Each time you return to a standing position, imagine stress and tension leaving your body. 

Bamboo Swaying:  In this exercise you will stand and allow your body to slowly sway back and forth like a bamboo in the wind.  The rocking motion helps to relieve tension.  If you feel little tremors through your body while doing this exercise, do not be alarmed.  This is one of the ways your body releases tension.

It is important to take a moment to scan your body after these grounding exercises to see how you feel. 

Do you feel more grounded?

  More connected to the earth below? 

Do you feel less tension or stress? 

Other Ways to Practice Mindfulness

In today’s society, most of us are used to doing more than one thing at a time.  This can lead to frustration, anxiety, burnout and even depression.  Trying to take care of our families, get our work done, prepare meals and keep the house clean can feel overwhelming.  One of your goals should be to try to do one thing at a time.  This can be learned by taking small steps. 

Make a list of what needs to be done starting with the most important tasks.  Begin with the first task on the list and try to let go of distractions that come your way.  I suggest silencing your cell phone and computer email during this time. 

If you find yourself worrying about different things or thinking about something else, take a few deep breaths and imagine those thoughts leaving your mind with your breathing.  If you find yourself doing more than one thing at a time, stop, and choose the thing on the top of the list and return to it.  This can be difficult at first but will become easier with practice.

Tell your intrusive thoughts to leave your mind.  Keep doing this until you get results.  There are several exercises that can be done to help you succeed.  Start to notice times where you are thinking about one thing only. 

How does this feel? 

Here are a few things that can be done to practice focusing on one thing only.  Try to do these exercises several times each day, especially when you are feeling stressed or overwhelmed.

  • Watch a fire. This can be in your fireplace or a campfire.  Don’t think about anything, just watch.
  • Watch the raindrops running down a window.
  • Listen to the ticking of a clock.
  • Listen to the ocean waves.
  • Breathe mindfully as explained above.
  • Watch trees blowing in the wind.

I also like to take a walk outside and observe nature when I get stressed.  Concentrating on something as simple as the beauty of a leaf or the bark on a tree can change your mindset. 

Michael Brown pictured with Final Thought written

With practice, somatic mindfulness can become an important tool to fight stress, anxiety, depression and burnout.  We started with breathing which I believe to be a very important first step to calm the body. A few months ago I wrote a post on anxiety.  This would be a great time to review that article.  It has more information on breathing techniques and other ideas to help relieve stress and anxiety.  When these exercises aren’t enough, don’t forget about our Anxiety Formula.  This is the best-selling product in our store and our customers love it.  Take a look at this video recorded by a friend of mine who uses the product.

We can all live a more productive, enjoyable life if we take some simple steps to take care of our mind and body.  You are reading this because you are committed to be a happier and healthier person.  Remember what I have been telling you all:

  • Get plenty of sleep.
  • Drink eight, 8 ounce glasses of water daily. More if you are sweating (exercise or hot weather).
  • Eat whole foods – stay far away from fast food, junk food and empty calories.
  • Exercise – Stay active. Find an exercise you like and do that activity for at least 30 minutes, 5 days per week.
  • Avoid alcohol and drugs. If you need a reminder why you shouldn’t drink alcohol, read my article on ethanolism.
  • Think positively and surround yourself with positive people.
  • Spend as much time with your happiness elements as possible!

That is all for this week.  I hope you are all staying safe during this COVID-19 outbreak.  PLEASE STAY HOME if you are not an essential worker.  This virus has turned out to be worse than we initially thought. 

Wash your hands often,

maintain a six-foot distance from others, and

stay isolated until this virus runs its course. 

We will get through this.

If you have any questions or comments, please feel free to contact me.  I welcome any interaction from my readers.  This blog is for you!

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.