Weight Loss Surgery May Not Relieve Acid Reflux

Reflux symptoms return in about half of patients who undergo gastric bypass, according to a study published online June 4 in Alimentary Pharmacology & Therapeutics.

Dag Holmberg, from the Karolinska Institutet in Stockholm, and colleagues assessed the long-term risk for remaining or recurring reflux symptoms after gastric bypass among all Swedish adults with preoperative reflux who underwent gastric bypass between 2006 and 2015 (2,454 participants; 81.7 percent women; mean age, 46.1 years).

The researchers found that during a median 4.6 years of follow-up, reflux recurred in 48.8 percent of participants within two years of gastric bypass and remained stable up to 10 years after surgery. A high preoperative dose of antireflux medication (incidence rate ratio [IRR], 1.77), older age (IRR, 1.12 comparing age >50 with <40 years), female sex (IRR, 1.28), and comorbidity (IRR, 1.26 comparing Charlson Comorbidity Index ≥2 with 0) increased the risk for recurring reflux.

"The treatment efficacy of gastric bypass on reflux symptoms might have been overestimated," the authors write. "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, that is, high dose of preoperative anti-reflux medication, older age, female sex, and comorbidity."

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