Background

Gastroesophageal reflux can improve or worsen after bariatric surgery depending on procedure type. Our goal was to compare patient reported symptoms of reflux after gastric bypass (GB) and sleeve gastrectomy (SG) based on preoperative symptom severity.

Methods

This study analyses data from a state-wide bariatric-specific registry that utilizes a validated patient-reported gastroesophageal reflux survey with symptom scores that range from 0 (no symptoms) to 5 (severe symptoms). We included 10,554 patients who completed a survey both at baseline and at 1 year following bariatric surgery between 2013 and 2017. We compared the incidence of improving and worsening reflux symptoms after GB and SG based on baseline symptoms.

Results

Overall improvement of reflux symptoms occurred in 30.4% of patients after SG and 30.8% after gastric bypass (p=0.7015). Patients with a baseline score of 0 (no symptoms) were more likely to develop new onset symptoms at one year after SG than GB (21.0% vs 7.6%, p<0.0001). Patients with a baseline score of 1-4 had a significantly higher likelihood of improved symptoms after GB than SG (see figure, p<0.001 for all analyses). Baseline severity of symptoms did not correlate with procedure type (Pearsons -0.05263 for GB and 0.05263 for SG).

Conclusions

Both SG and GB improved reflux symptoms after surgery with GB demonstrating superior results. We found no correlation between preoperative reflux symptom severity and procedure choice. Using a validated patient survey for gastroesophageal reflux can help set appropriate expectations of symptoms after bariatric surgery.