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Why Weight Loss Surgery Might Fix Your Acid Reflux

September 06, 2023

While everyone suffers through the occasional bout of heartburn, acid reflux is often much more serious when you’re obese.

You may already suspect you need something besides antacids. But did you ever guess the answer might be weight loss surgery?

“For many patients, surgery is the solution,” says Kenneth M. Schwartz, MD, surgical director of Hartford HealthCare’s Swallowing and Reflux Program in Cheshire, Meriden and Southington.

What does weight have to do with acid reflux?

“Obesity is a major risk for acid reflux because you’re holding more weight,” says Dr. Schwartz. “It has to do with the pressure.”

When you lie down, the weight of your belly pushes on your stomach. Enough pressure can squeeze stomach acid back up your esophagus — aka acid reflux.

Sometimes, excess weight can also lead to a hiatal hernia, where part of your stomach bulges up into your chest. That can disrupt the barrier between your stomach and esophagus, allowing stomach contents to flow back up.

Both scenarios can cause acid reflux and its chronic form, gastroesophageal reflux disease (GERD).

How can weight loss surgery help with acid reflux?

If you’re obese, weight loss surgery can be a game changer on numerous health fronts. The benefits include a cure for type 2 diabetes, better sleep, less joint pain, resolution of high blood pressure — and for many people, a cure for acid reflux.

Different procedures help in different ways.

• A sleeve gastrectomy removes 75% of your stomach, the part that produces appetite-inducing hormones. At the same time, reducing your body weight relieves excess pressure, and therefore stops reflux.
• A gastric bypass dramatically reduces your stomach size and creates a low-pressure situation, which means food moves through more quickly and doesn’t have the chance to back up into your esophagus.
• If you have a hiatal hernia that’s causing acid reflux, your surgeon may (or may not) repair it at the same time as either weight loss procedure.

Today, these surgeries are safer and more common than ever. “Things have come a long way in terms of surgical technique, proper diagnostics and good candidates,” says Dr. Schwartz.

> Related: Bariatric Surgery Can Help With These 5 Conditions

Could it be right for you?

For most people, it boils down to three questions.

• What’s causing your acid reflux?
• What’s your BMI?
• What’s your overall health?

For example, if your acid reflux is caused by something like a faulty valve in your esophagus, weight loss surgery may never even enter the picture, depending on your body weight. In that case, a procedure targeted for reflux alone may be the way to go. If obesity is your main issue, keep in mind that weight loss surgery is usually only an option for patients with a BMI of 35 or higher who have additional medical conditions.

One thing is certain: It’s worth seeing an expert in swallowing and reflux, or an expert in bariatrics — or, ideally, a team that specializes in both.

“There’s a crossover. We see patients who want to lose weight, but also have reflux. We see patients who want their reflux treated, but are also obese,” says Dr. Schwartz. “With the right treatment, we give you your life back.”