Heartburn After Bariatric Surgery? Discover Why & What to Do

Written by Kristen Carli, RD and medically reviewed by Dr. Stephen Boyce, MD

Heartburn can be an uncomfortable and rather unexpected symptom after bariatric surgery. While bariatric surgery is highly effective for weight loss, because changes are made to the digestive system, symptoms like acid reflux and heartburn can often result. Recognizing the signs of heartburn is essential for managing this discomfort. In this article, we’ll explore why heartburn occurs after bariatric procedures, discuss the symptoms to watch for, and offer practical strategies to help you find relief, including the importance of bariatric vitamins to support recovery and nutrition.

What is Heartburn?

Heartburn is a burning feeling in the chest that often sneaks up toward your throat. This sensation is caused from stomach acid making its way up into the esophagus. 

Heartburn can be set off by a variety of things, from spicy or fatty foods to certain drinks like coffee, alcohol, or even lying down after you eat. While usually harmless, if heartburn happens frequently, it could be a sign of something more serious, like gastroesophageal reflux disease (GERD). 

Symptoms and Causes of Heartburn after Bariatric Surgery

Bariatric procedures, particularly sleeve gastrectomy, can often result in heartburn. This is because, during this surgery, a large portion of the stomach is removed. The reduction in stomach size can lead to build up of stomach acid, sometimes overflowing into the esophagus. When this happens, patients may report burning chest pain, regurgitation, and even difficulty swallowing after surgery. 

Bariatric Surgery Techniques and Heartburn Risk

The type of bariatric procedure you choose has a role in the potential for heartburn. As discussed, sleeve gastrectomy procedures have been shown to increase the risk of developing or even worsening GERD symptoms. However, roux-en-Y gastric bypass (RYGB) procedures have been associated with a reduction in GERD symptoms. This is a great option for those with preexisting reflux. Additionally, adjustable gastric banding has shown quite mixed results. Some patients see a reduction in GERD symptoms, while others develop new reflux issues and sometimes accompanied by constipation after bariatric surgery. Consuming bariatric snacks like bariatric protein bars can also help maintain energy levels without overburdening the stomach, which may reduce heartburn symptoms.

Diagnosis of Heartburn after Bariatric Surgery

If you’ve had bariatric surgery and think you may have heartburn, here’s what to expect when getting a diagnosis. First, your doctor will gather a history of your symptoms. They will also ask about your diet and lifestyle.

Once this information has been gathered, it’s likely that your physician will conduct a few diagnostic tests including an upper endoscopy, esophageal manometry, and pH monitoring. These tests help to determine if you have reflux by measuring the amount of stomach acid in your esophagus or testing the function of your esophagus.

You may even undergo imaging studies such as Barium swallow X-rays. These tests allow your physician to visualize the structural changes in your esophagus and look for other issues that may be contributing to your symptoms such as strictures or hiatal hernias. 

Treatment Options for Heartburn

If you and your physician determine you are suffering from heartburn, there are a few treatment options to consider. Before starting medication, you may be advised to make some dietary changes. These can include avoiding spicy foods, carbonated beverages, mint, coffee, alcohol, tomatoes, garlic, tea, chocolate, onions, and fatty foods. Additionally, you may be advised to lose weight and quit smoking, or even sleep at an incline, as sleeping flat may allow stomach acid to flow up the esophagus.

Depending on the severity of your heartburn, you may also need medications to manage your symptoms. These could include over-the-counter antacids, H2 blockers, and proton pump inhibitors. 

In severe cases, if you’ve undergone a sleeve gastrectomy and are still suffering, your doctor may even suggest converting to a roux-en-Y gastric bypass.

When to Seek Medical Attention?

If dietary changes are not enough to solve your heartburn, and you are suffering more than twice per week, be sure to reach out to a healthcare provider. Seek immediate medical care if you struggle swallowing, vomit blood, experience unexplained weight loss, or have black stools. These severe symptoms may indicate serious complications. 

If you’ve just undergone bariatric surgery, be sure to keep these symptoms in mind and report any new or worsening heartburn, bowel problems after bariatric surgery, or other issues to your healthcare provider immediately.

By recognizing the triggers and symptoms of heartburn early, making dietary adjustments, and seeking appropriate treatment, you can keep heartburn under control and stay on track with your weight loss journey. If you experience frequent or severe symptoms, consult your healthcare provider to explore the best options for you, including potential surgical adjustments if needed. Remember, addressing heartburn promptly can improve your quality of life and help you fully enjoy the health benefits of your bariatric surgery.

Conclusion

Experiencing heartburn after bariatric surgery is a common but manageable issue. This condition is often related to changes in stomach structure, particularly following procedures like sleeve gastrectomy, which can lead to increased acid reflux. Recognizing the symptoms and potential causes of post-surgery heartburn is crucial for effective management. Practical strategies, such as dietary adjustments—avoiding spicy, fatty, and acidic foods—along with lifestyle modifications like sleeping at an incline, can significantly alleviate symptoms. For more persistent cases, medications or, in severe instances, further surgical intervention may be necessary, with a possible conversion to a roux-en-Y gastric bypass for better symptom control.

If symptoms persist beyond dietary and lifestyle changes, it’s essential to consult with a healthcare provider. Seeking timely medical attention, especially for severe symptoms, can prevent complications and enhance recovery. By managing heartburn effectively, individuals can fully enjoy the health benefits of their bariatric surgery and improve their quality of life.

For a balanced recovery, incorporating bariatric-friendly products, such as those from Bari Life, can support nutritional needs and help maintain energy levels without exacerbating heartburn symptoms. Bari Life offers products designed for bariatric patients, which can be a beneficial addition to a post-surgery diet.

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