Researchers have suggested the efficacy of gastric bypass in the treatment of reflux symptoms may have been overestimated, with a new study showing around half of operated patients require continuous anti‐reflux medication.
Researchers assessed the long‐term risk of remaining/recurring reflux symptoms after gastric bypass in 2,454 adults in Sweden with preoperative reflux who underwent gastric bypass between 2006 and 2015, with complete follow‐up through 2016. Participants were followed for a median of 4.6 years. The main outcome was remaining/recurring reflux defined by the dispensing of proton pump inhibitors (PPI) and histamine‐2 receptor antagonists (H2RA) after gastric bypass.
The researchers found reflux symptoms remained/recurred in around 48 per cent of participants in the second year of gastric bypass and remained stable up to 10 years after surgery. The risk of reflux was similar comparing laparoscopic with open gastric bypass.
Risk factors for recurring reflux included high preoperative dose of anti‐reflux medication, older age, female sex and comorbidity.
Writing in Alimentary Pharmacology & Therapeutics, the authors said: “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 post‐operative reflux.”