Gastric Band Weight-Loss Surgery Can Boost Reflux

Patients often did lose weight after banding, the researchers found, and this reduction in weight did not immediately encourage GERD. In fact, in some cases, post-procedure weight loss appeared to moderately reduce some reflux disease symptoms, the researchers said.

However, the inserted gastric band often seems to shift in place over time, they said, leading to a reversal of any initial benefit and a gradual worsening of GERD symptoms.

Based on these findings, Friedenberg and his team concluded that gastric bypass may be "the preferred surgical technique" with specific regard to GERD risk. But they also pointed out that more rigorous studies need to be conducted to better understand the how's and why's of reflux disease in the context of weight-loss surgery.

One expert said the current work highlights the need to carefully assess the pros and cons of each weight-loss procedure.

"Gastric bypass is the most common and the most successful of the surgical procedures to deal with obesity," noted Dr. Anthony A. Starpoli, an attending gastroenterologist at Lenox Hill Hospital and director of gastro-esophageal research and endo-surgery at St. Vincent's Hospital, both in New York City. "But the advantage to the banding procedure is that, although it will not be an effective option for all patients -- depending on the level of obesity -- it's a lot less aggressive than bypass and has a lot less morbidity associated with it. And it's much more reversible. So, there are reasons some patients might choose that option."

"However, that said, there is no ideal procedure," Starpoli cautioned. "Both bypass and banding are not without their set of complications. And this study illustrates that while solving one problem, perhaps you worsen another. So, I would say that if you're going into any of these procedures to deal with obesity, and you have significant reflux, you definitely first need to have an appropriate evaluation as if you were considering an anti-reflux procedure."

More information

There's more on GERD at U.S. National Institutes of Health.

SOURCES: Frank K. Friedenberg, M.D., associate professor, section of gastroenterology, Temple University School of Medicine, Philadelphia; Anthony A. Starpoli, M.D., attending gastroenterologist, Lenox Hill Hospital, New York City, and director, gastro-esophageal research and endo-surgery, St. Vincent's Hospital, New York City; August 2008,The American Journal of Gastroenterology