Gastric Bypass Is Not Effective Against GERD in the Long Term for All Patients

Gastric bypass may not have an overarching effect on gastroesophageal reflux disease (GERD) as shown by previous research, according to the authors of a new study. The findings show that GERD symptoms reappeared within 2 years nearly 50% of the time after gastric bypass, despite quickly diminishing after the surgery.

To analyze the long-term effect gastric bypass has on reflux symptoms, the researchers studied data on 2454 participants with preoperative reflux who were taking proton-pump inhibitors (PPIs) or histamine‐2 receptor antagonists (H2RAs) for their reflux.

IF YOU LIKE THIS, READ MORE...

Study Suggests Water Can Reduce GERD Risk Among Women

Long-Term PPI Therapy Does Not Induce Significant Risk of Adverse Events

The participants underwent gastric bypass in Sweden between 2006 and 2015. Complete follow-up was conducted through 2016, with a median of 4.6 years of follow-up.

Remaining or recurring reflux symptoms among the participants was defined as PPI or H2RA use for more than 6 months after gastric bypass.

Within the first year after gastric bypass, reflux symptoms remained or recurred in 55.8% of the participants. Within 2 years after the surgery, 48.8% of participants experienced reflux, with reflux incidence remaining around 50% for up to 10 years after surgery.

Risk factors for recurrent reflux included higher doses of anti‐reflux medication before surgery, being older than 50 years, being a woman, and having comorbidities.

While the treatment effect of gastric bypass on reflux symptoms lasts for many years, the authors noted that the effect does not improve over time after surgery, with many participants having to continue their anti‐reflux medication.

“Gastric bypass is an effective and long‐lasting treatment of GERD in only approximately 50% of patients with severe obesity,” the researchers concluded.

—Colleen Murphy

Reference:

Holmberg D, Santoni G, Xie S, Lagergren J. Gastric bypass surgery in the treatment of gastro‐oesophageal reflux symptoms [published online June 4, 2019]. Aliment Pharmacol Ther. doi:10.1111/apt.15274.