Heartburn Prevention 101: How to Prevent Heartburn After Bariatric Surgery

Does bariatric surgery cause heartburn or prevent it? The answer is both, depending on the weight loss procedure. 

As a specialist in bariatric surgery who has also helped many patients overcome heartburn and gastroesophageal reflux disease (GERD), Amir Mehran, MD, FACS, FASMBS, at University Bariatrics, has the expertise to explain your options and help you make the best choices for preventing heartburn after bariatric surgery.

About heartburn

Heartburn occurs when digestive acids come out of your stomach and into the esophagus (the tube connecting your mouth to your stomach).

A round muscle between your esophagus and stomach, the lower esophageal sphincter (LES), opens to let food enter your stomach and then closes to keep digestive acids in the stomach.

When the muscle weakens, or there’s too much pressure in your stomach, the acids get into your esophagus, irritating the tissues and causing a burning sensation. This problem is called heartburn because you feel the (often severe) burning in your upper chest near your heart. 

Repeated and frequent bouts of acid reflux indicate you have GERD. GERD causes inflammation in the esophageal lining. 

Over time, the inflammation causes scarring and narrows the tube. In severe cases, long-term exposure to stomach acid changes the lining, resulting in a precancerous condition called Barrett’s esophagus. 

The connection between heartburn and bariatric surgery

The interesting thing about bariatric surgery is that one procedure prevents heartburn while another causes the problem. 

Gastric bypass

Gastric bypass surgery prevents acid reflux. Many people have GERD before bariatric surgery because excess weight places pressure on their stomachs and weakens the LES. 

The bypass procedure redirects stomach acid into the lower part of your small intestine, moving it away from the LES. Additionally, rapid weight loss after surgery dramatically reduces the pressure on your stomach. These changes effectively treat heartburn and GERD. 

Sleeve gastrectomy

Heartburn is a well-known side effect after a sleeve gastrectomy because the pressure in your stomach increases after the procedure. Four in 10 people who didn’t have GERD before surgery develop it afterward. And symptoms worsen for many who had heartburn before their surgery.

Preventing heartburn after bariatric surgery

Here are six tips for preventing heartburn after a sleeve gastrectomy: 

1. Stay on your weight loss program

Your ongoing weight loss relieves abdominal pressure. Even if you experience heartburn after your sleeve gastrectomy, it should improve as your weight goes down.

2. Keep your meals small

Eating small meals after bariatric surgery lowers your risk of complications, such as stretching your stomach. Small meals also help prevent heartburn. Putting too much food in your stomach significantly increases the pressure and worsens acid reflux.

3. Avoid foods that cause acid reflux

Certain foods aggravate acid reflux and GERD because they boost the pressure in your stomach. Your symptoms may improve if you limit or eliminate:

• Onions
• Peppermint
• Citrus fruits
• Garlic
• Spicy foods
• Tomatoes
• High-fat foods
• Fried foods
• Alcohol
• Dark chocolate
• Carbonated beverages

You shouldn’t go to bed or lie down to rest for two hours after eating. It also helps to sleep with your head elevated.

4. Take medications

Taking an over-the-counter antacid or proton pump inhibitor may be all you need to ease heartburn, even after bariatric surgery. Antacids neutralize stomach acid, while proton pump inhibitors reduce stomach acid production.

You may need a prescription-strength medicine if over-the-counter products don’t help.

5. Convert to a gastric bypass

If you struggle with severe heartburn and GERD after a sleeve gastrectomy, we can perform revisional bariatric surgery to convert it to a gastric bypass. 

6. Consider getting the LINX™ device

The LINX device is a ring of tiny magnetic beads. During a minimally invasive laparoscopic procedure, your surgeon places the LINX around the LES. The magnets are strong enough to prevent acid reflux but weak enough to let food pass through.

If you need help for heartburn after bariatric surgery, don’t wait to talk with the team at University Bariatrics. As specialists in general and bariatric surgery serving the greater Los Angeles area, we can evaluate your health needs and recommend the best treatment.

Call the office in Thousand Oaks or Northridge, California, or request an appointment online today.