Background

Gastro-Esophageal Reflux Disease (GERD) is a common comorbidity in patients with severe obesity. Bariatric surgery often resolves GERD but de-novo GERD may also develop postoperatively. The aim of this study was to describe the relationship of GERD and bariatric surgery. Method: Data of all adult patients from an academic MBSAQIP center who underwent primary Sleeve Gastrectomy (SG) or Roux-en-Y Gastric Bypass (RYGB) between 2018-2020 with at least one year of follow up were reviewed. Criteria for GERD diagnosis was the dependence to anti-reflux medications. Frequency and contributing factors of GERD resolution or denovo GERD development was assessed. Results: Of 339 patients, 124(36.6%) had undergone SG and 215(63.4%) RYGB. The overall rate of GERD at the time of surgery was 34.5% while at the 12-month follow-up it decrease significantly to 26.5% (P=0.006). GERD resolution achieved frequently and comparably after both RYGB (50%) and SG (43.5%) (OR=1.3 (0.5- 3.2); P=0.31). Denovo GERD was seen in 14.5% of the patients and it occurred less among RYGB vs SG patients (11.8% vs 18.4% OR=0.6 (0.3-1.3);P=0.22). Conclusion: Although preoperative GERD resolves in about half of the patients after bariatric surgery, new onset GERD occurs in a substantial number as well. While we identified a trend toward improved outcomes after RYGB compared with sleeve gastrectomy differences were not statistically significant. The risk factors for either conditions are different and not necessarily the opposite of each other. Further study of risk factors for lack of GERD resolution or de-novo GERD development is needed.