Has weight loss surgery long lasting relieving effect on GERD symptoms?

Individuals who are obese often experience heartburn and other symptoms of Gastro‐oesophageal reflux disease, GERD. Previous research indicates that gastric bypass surgery for obesity helps alleviate symptoms of Gastro‐oesophageal reflux disease, GERD in the short term, but a new study finds that these benefits often are not long-lasting. The study has been published in the Journal of Alimentary Pharmacology & Therapeutics.

Gastro‐oesophageal reflux disease (GERD) is defined by troublesome heartburn and regurgitation and occurs in 10%‐20% of adults in Western populations. GERD is associated with reduced health‐related quality of life and increased risk of oesophageal adenocarcinoma. Together with heredity and tobacco smoking, obesity is the most established risk factor for GERD. The prevalence of GERD is three‐ to sixfold increased among individuals with a body mass index (BMI) ≥35, as compared to those with a normal BMI. Consequently, patients with obesity and GERD are recommended to lose weight, which can reduce reflux symptoms.

The researchers conducted a study to assess the long‐term risk of remaining/recurring reflux symptoms after gastric bypass. This was a nationwide cohort study of all adults with preoperative reflux who underwent gastric bypass in Sweden between 2006 and 2015, with complete follow‐up through 2016. The outcome was remaining/recurring reflux symptoms, defined as the use of proton pump inhibitors or histamine‐2 receptor antagonists for >6 months after surgery.

In the study of 2454 patients (mostly women) who had surgery for obesity and who were also taking medicines for acid reflux, symptoms of acid reflux improved in most patients shortly after surgery, but they returned in almost half of all patients within 2 years. Symptoms were more likely to return in women, older individuals, and those with other serious medical problems.

"Physicians and patients should be aware of the limited effect of gastric bypass on reflux in patients with severe obesity, particularly in those with risk factors for postoperative reflux," the authors wrote.