Gastroesophageal reflux disease related to laparoscopic sleeve gastrectomy

Obesity remains a global public health burden. The most common surgical approach for this condition worldwide is laparoscopic sleeve gastrectomy (LSG). Although it is highly effective at achieving both short- and long-term weight loss, comparable to outcomes demonstrated by Roux-en-Y gastric bypass, there are growing concerns about the development or worsening of another prevalent and morbid condition, gastroesophageal reflux disease (GERD), following sleeve gastrectomy (SG). In this narrative review, we summarize current concerns related to GERD in the context of SG. We review the pathophysiologic mechanisms that predispose the SG anatomy to GERD, focus on the prevalence of de novo and worsening GERD and its associated complications, Barrett's esophagus, review expert recommendations for GERD evaluation pre- and post-surgery, and discuss therapeutic options for those with severe GERD following SG.