Weight loss surgery sometimes worsens acid reflux

Gastric banding, a popular type of weight loss surgery, can interfere with the normal motion of the esophagus and, in some cases, worsen acid reflux disease, which occurs when stomach juices flow back into the esophagus, according to a new study.

Based on the results, the researchers recommend a different weight loss procedure for patients with impaired movement of the esophagus and severe reflux on preoperative tests.

Previous studies have produced conflicting results regarding the effect of gastric banding on acid reflux and esophagus motion, according to the report in the Archives of Surgery.

Dr. Michel Suter and colleagues, from Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland, assessed the outcomes of 43 obese patients who underwent keyhole or "laparoscopic" gastric banding. Esophagus acid and movement tests were performed before and several months after the operation.

The procedure did not seem to affect the rate of reflux symptoms, such as Heartburn, the investigators note. However, there was a trend toward more esophagus movement problems after surgery.

Gastric banding was associated with a weakening of the normal contractions that occur in the lower esophagus.

Aside from a few patients who developed massive reflux postoperatively, gastric banding was generally associated with a drop in esophagus acid levels as well as with fewer reflux episodes.

The team says doctors should consider performing a different type of weight loss operation, known as gastric bypass, for patients with evidence of esophagus acid or movement problems before surgery.

SOURCE: Archives of Surgery, July 2005.