Expert: John Pilcher, MD - 12/16/2011

Question
I had Gbs w/r-y, I have had acid reflux severely and when I went back to the doctor who did my surgery he said that there was nothing he could do except give me Nexium. I had surgery 2002 and nothing seems to work. I get ulcers and end up on a diet for that and the carbs have made me gain weight. Am so frustrated! I had the most extreme surgery and can't get.the weight to come back off and reflux is really killing me. How do I get back on track and lose this reflux?

Answer
Brenda,
You are describing a really challenging situation. You did not specifically write it in your question, but I presume that your surgeon has checked your anatomy to be sure there is no sign of obstruction or blockage, and also to be sure that there is not any fistula connecting your gastric pouch to your main bypassed stomach which produces acid.  I suspect that your surgeon has also looked for the presence of a hiatal hernia, because the presence of a hiatal hernia after gastric bypass can promote reflux with otherwise normal anatomy.

If all of these are true, then it may that the only thing to be done is to treat your condition with acid blocking medicines (Such as Nexium) and perhaps soothing medicines such as Carafate.  Nevertheless, it remains a good idea for you to seek a second opinion with an experienced bariatric surgeon in your area. A second surgeon should be able to review your imaging studies such as Upper G.I. series and be really sure that there is not anything anatomically correctable in your situation.  Your primary physician should be able to help you find an experienced bariatric surgeon for a second opinion.

In your question, you mentioned intake of carbohydrates as part of the diet therapy for ulcer. I am not familiar with this plan, and I don't really believe that carbohydrates are more beneficial than proteins and vegetables for healing. You will have to go with your actual symptoms on this issue, but recognizing the negative side effects of carbohydrates it is worth reconsidering this plan.

Best wishes,
Dr. JP