Background

Gastroesophageal reflux disease (GERD) is a known complication/side effect of the sleeve gastrectomy. Starting at the end of 2021/beginning of 2022, our bariatric surgeons started to notice an increase in the number of patients presenting after a sleeve gastrectomy with symptoms of GERD. Due to the increasing number of patients being seen within our practice immediately following surgery with GERD symptoms, and to help with potential dehydration, emergency room visits, and readmissions, our hospital's Metabolic and Bariatric Surgery Committee decided to initiate a GERD protocol for the bariatric program in order to decrease the number of patients presenting with these symptoms immediately following surgery. In conjunction with the protocol, we initiated a quality improvement project surrounding GERD to help us in better understanding what might be some of the root causes of symptoms immediately following surgery. The quality improvement project focused on patient education. In addition, as part of our GERD protocol, we utilized a validated GERD questionnaire, the GERD-Health Related Quality of Life (HRQL) questionnaire, as a tool to help with quantifying GERD symptoms. This questionnaire was given to patients at three different time periods:pre-surgery during their review, 2-week follow-up post-surgery, and 6-8 week follow-up post-surgery. From this, our results seem to indicate that GERD symptoms are largely behavior driven in those first initial weeks following surgery. We also discovered by looking at % excess body weight loss that patients having the highest GERD-HRQL score also tended to lose the least amount of weight in those first weeks.