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Persistent heartburn after the sleeve

Weight Doctors® REVISION Reflux after gastric sleeve

Persistent heartburn after gastric sleeve surgery can be treated. We clarify the cause – such as a hiatal hernia, a narrowing or your anatomy – and treat it in a targeted way, up to conversion to a bypass.

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How your therapy is structured

Two building blocks.
One plan.

The Weight Doctors® MEMBERSHIP is the foundation of every therapy: medical oversight, progress monitoring and aftercare. The treatment you choose together with your specialist builds on it.

Building block 1

Weight Doctors® MEMBERSHIP

The foundation for every Weight Doctors® therapy – with the tools that support your treatment and record your progress for your medical consultations.

  • Weight Doctors® AppKeep an eye on weight, activity and sleep, for iOS and Android
  • Digital body scalesBluetooth scales – the readings flow straight into the app
  • 3D BodyscanMeasure body composition objectively, up to twice a year
  • Priority access to specialistsby phone, video or on site, without a long wait
  • 360 coaches and Weight Doctors® MiraNutrition and behaviour in everyday life, aftercare with your coaches
  • E-prescription servicePrescriptions issued digitally – after medical approval
More on the Membership
Building block 2

Weight Doctors® REVISION Reflux after a gastric sleeve

Persistent heartburn after gastric sleeve surgery can be treated. We clarify the cause – such as a hiatal hernia, a narrowing or your anatomy – and treat it in a targeted way, up to conversion to a bypass.

Procedure
Endoscopic or surgical
Duration
individual
Price
from €900
Costs

The Membership does not replace a medical decision: whether treatment makes sense, and which one, is decided by your specialist after a medical assessment.

In comparison

Treatment options for reflux after a sleeve

Endoscopic or surgical, depending on the cause. Which procedure is suitable is decided by the diagnostic work-up.

  • Conversion to a bypass procedure

    Surgical: the gastric sleeve is converted into a bypass procedure. This comes into question for persistent reflux after a sleeve and can also support weight loss.

  • Endoscopic and minimally invasive procedures

    Where suitable, we use gentle, minimally invasive revision techniques – avoiding a major procedure where possible.

  • Restoring normal conditions

    The aim is an anatomy that resolves the reflux – tailored to your situation.

Personally here for youDr. med. Oliver Scheffel · Bariatric surgery

Your guide

Reflux after a gastric sleeve at a glance

Why heartburn can develop after the sleeve, why you should have it checked and how we treat the cause.

Why reflux can develop after the sleeve

The gastric sleeve is an effective procedure for weight loss. As after any obesity surgery, however, reflux can in some cases occur afterwards, or an existing one can get worse. This is not a failure and can be treated – there is usually a specific cause behind it:

Hands guiding the gastroscope, with the monitor in the background
  • Changed pressure conditionsThe slim gastric sleeve no longer has a reservoir, and the pressure inside it is higher – a known phenomenon.
  • Hiatal herniaPart of the stomach slides up through the opening in the diaphragm. It sometimes already existed before the surgery, unnoticed.
  • Narrowing (stenosis)A narrowing in the sleeve can obstruct the passage of food and promote reflux.
  • Individual anatomyEvery body is different. We look for your very own trigger – it determines the right therapy.

Advantages of Weight Doctors® REVISION

  • Specialised expertiseAn experienced team, specialised in obesity surgery and corrective procedures.
  • Surgical and endoscopicSurgical and endoscopic revision techniques under one roof – we choose what suits your situation.
  • Nationalklinik WertheimTreatment in our specialised centre for obesity surgery.
  • Individual treatment planningNo one-size-fits-all approach: your treatment path is tailored exactly to your situation.
  • Also after surgery at another clinicOur revision clinic is open to all patients – regardless of where your procedure took place.
  • Comprehensive aftercareWe also continue to support you after the revision – with our 360-degree care.

Typical symptoms – and why you should not accept constant heartburn

Persistent, untreated reflux can damage the oesophagus in the long term – up to changes in the mucous membrane. On top of that comes the strain in everyday life.

Acid blockers (PPIs) relieve the symptoms but do not remove the cause. Anyone who takes them long term without things really getting better should therefore have the source of the reflux clarified. Our aim is that you no longer need the acid blockers because the cause has been resolved.

You will find everything about the specialist clinic, about other symptoms after stomach surgery and about aftercare under Weight Doctors® REVISION. Typical reflux symptoms after a sleeve:

Weight Doctors® adviser in conversation with a patient
  • Persistent heartburn and acid regurgitation
  • Burning behind the breastbone, especially when lying down and at night
  • Difficulty swallowing or a feeling of pressure when eating
  • Chronic irritable cough, hoarseness, a lump in the throat
  • Long-term use of acid blockers (PPIs) without real improvement
  • Poor sleep because the symptoms get worse at night

“Reflux after a gastric sleeve is not a fate you have to manage with tablets.”

Dr. med. Oliver Scheffel

Our approach – step by step

Before we treat, we clarify the exact cause – your therapy is built on this:

Procedure room for endoscopies at the Weight Doctors® Nationalklinik
  1. Initial contactIn person, by telephone or by video consultation.
  2. Detailed analysisWe record your symptoms, your medication and your medical history.
  3. Targeted diagnosticsThe core of the diagnostic work-up is the stomach examination (gastroscopy). If necessary, functional tests are added, such as imaging of the swallowing process or a pH measurement.
  4. Clear identification of the causeAt the end there is a clear answer: is there a hiatal hernia, a narrowing (stenosis) or something else? We name the reason for your symptoms.
  5. Individual treatment strategyYour plan – from gentle procedures to conversion to a bypass.

Conversion to a bypass procedure

For persistent reflux after a sleeve, converting the gastric sleeve into a bypass procedure comes into question. In a gastric bypass, a small stomach pouch is connected directly to the small intestine – this can create conditions intended to resolve the reflux. At the same time, the procedure can support weight loss.

The procedure takes place at the Weight Doctors® Nationalklinik in Wertheim, carried out by specialists who focus on obesity surgery and corrective procedures. Whether it is the right path for you is decided by the diagnostic work-up.

Hands of the surgical team guiding the instruments through small access points in the abdominal wall
  • GermanyNetherlandsDr. ScheffelSpecialist in general and bariatric surgery
  • GermanyAustriaProf. MillerSpecialist in general and visceral surgery
  • GermanyDr. SchüderSpecialist in general, visceral and vascular surgery / specialist in specialised visceral surgery
  • GermanyDr. JohnSpecialist in internal medicine & gastroenterology

All specialists

Gentle procedures where possible

Not every case of reflux requires a major procedure. Where it is suitable, we use gentle, endoscopic and minimally invasive revision techniques. The aim is always an anatomy that resolves the reflux for the long term – tailored to your situation and your findings.

Female specialist with an endoscope in the procedure room

What does the treatment cost – and what does the German health insurance pay?

The treatment is part of Weight Doctors® REVISION and is possible as a self-pay service from €900, also with payment in instalments.

With proven reflux (e.g. by endoscopy) and an indication in line with the guidelines, there is a chance of cost coverage by your German statutory health insurance. There is no prior application: before the procedure, we check all the requirements for you. You do not have to speak to your health insurer; billing takes place directly afterwards. This is how the costs are divided:

What statutory health insurance pays*

  • Surgery by a specialist
  • Anaesthesia
  • Materials and medication in the clinic
  • Double room at the Nationalklinik
  • Informed consent discussion
  • Aftercare in the clinic
  • No follow-up cost insurance needed

* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.

What you pay privately

  • Private medical pre- and post-treatment examinations

MMK+ programme

multimodal programme including Weight Doctors® MEMBERSHIP all-in

  • App with Weight Doctors® Mira, body scales and 3D Bodyscan
  • Specialists around the clock
  • Personal coach
  • Telemedicine and e-prescription
  • Communication with the German health insurer
  • Free choice of clinic for preliminary examination and aftercare
Two paths to stomach reduction on German health insurance

Usual pathwith an advance application to the German health insurer

Weight Doctors®Without advance application

ConsultationInitial consultation and indication
MMKSix months of nutrition, exercise and psychology
ApplicationApplication for cost coverage with all documents to the German health insurer
Expert reportReview by the Medical Service
DecisionWaiting for the decision – appeal if rejected
SurgeryProcedure after approval
ConsultationWe check your medical indication: BMI, related conditions, previous attempts to lose weight.
MMKSix months of nutrition, exercise and psychology – we organise all the appointments. With a primary indication, it is not required.
Final checkBefore surgery, we check all the requirements for you. You do not have to speak to your German health insurer.No advance application
SurgeryYour procedure – billing with your German health insurer follows directly after surgery.

* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.

More on cost coverageAll prices

Paying in instalments: how it works

If you would like to spread the costs over a longer period, payment in instalments via our partner medipay is possible. You decide the instalment amount and term yourself; medipay reviews your application promptly. You submit the application together with us during your consultation, by phone or entirely paperless online – more under Pay in instalments.

The requirement is sufficient creditworthiness. In detail:

  • Main residence in Germany
  • no negative Schufa entries
  • employed or retired, with disposable income
  • Students, trainees and homemakers can enter a second person from the same household as the borrower – a parent, child, spouse or partner

Apply for instalmentsMore on instalments

Instagram · Reflux after a gastric sleeve

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Your specialists

In specialist hands.

39 doctors in Germany, Austria, the Netherlands, the United Kingdom and South Africa – at the Weight Doctors® Nationalklinik in Wertheim and at your location.

  • GermanyNetherlandsDr. ScheffelSpecialist in general and bariatric surgery
  • GermanyAustriaProf. MillerSpecialist in general and visceral surgery
  • GermanyPD Dr. WichmannSpecialist in visceral surgery & expert in endobariatrics
  • GermanyM. MargolinsSpecialist in general surgery
  • GermanyM. ShalabiSpecialist in general and visceral surgery
  • GermanyNetherlandsDr. JennerSpecialist in visceral surgery / specialised visceral surgery
  • GermanyDr. SchüderSpecialist in general, visceral and vascular surgery / specialist in specialised visceral surgery
  • GermanyA. SaberSpecialist in orthopaedics and trauma surgery
  • NetherlandsProf. GreveSpecialist in visceral and bariatric surgery
  • South AfricaDr. HanningtonSpecialist in surgery
  • South AfricaDr. MabeSpecialist in surgery
  • South AfricaDr. WolmaransSpecialist in surgery

All specialists

Frequently asked questions

Questions about Weight Doctors® REVISION Reflux after a gastric sleeve

Your question isn’t listed? Your specialist will take time for it during the consultation.

Why did I develop reflux after the gastric sleeve?

The narrow gastric sleeve no longer has a reservoir, and the pressure inside it is higher – this can promote reflux. Often a hiatal hernia that was sometimes unnoticed beforehand, or a narrowing in the sleeve, is added. We clarify the exact cause through diagnostic tests.

Did I do something wrong?

No. After gastric sleeve surgery, as after any obesity surgery, reflux can in some cases occur or get worse. This is not a failure but a known consequence that can be treated.

How do I recognise reflux after a sleeve?

Typical signs are persistent heartburn and acid regurgitation, burning behind the breastbone – especially when lying down and at night –, difficulty swallowing, an irritable cough, hoarseness or a lump in the throat. If several of these apply, have the cause clarified before secondary damage develops.

Is reflux after a sleeve dangerous?

Persistent, untreated reflux can damage the oesophagus in the long term, up to changes in the mucous membrane. That is why constant heartburn should be clarified and treated, not just masked with tablets.

Do I have to take acid blockers (PPIs) for life?

Not necessarily. If the cause is resolved, many patients no longer need the acid blockers afterwards. That is exactly the aim of the treatment.

How is the cause determined?

With a stomach examination (gastroscopy) and, if necessary, functional tests, such as an examination of the swallowing process or a pH measurement. This shows whether, for example, there is a hiatal hernia or a narrowing (stenosis).

Does conversion to a bypass help against heartburn?

For persistent reflux after a sleeve, converting the gastric sleeve into a bypass procedure comes into question. It addresses the cause and can also support weight loss. How the bypass is constructed is explained on the page Gastric bypass.

Is it possible without a major operation?

Where it is suitable, we use gentle, minimally invasive revision techniques – avoiding a major procedure where possible. What is possible for you is shown by the diagnostic work-up.

I was operated on at another clinic. Can I still come?

Yes, that is exactly when you are in the right place with us. The revision clinic is open to everyone, regardless of where your gastric sleeve was performed.

Does the German health insurance cover the treatment?

With proven reflux, for example by endoscopy, and an indication in line with the guidelines, there is a chance of cost coverage. There is no prior application: before the procedure, we check all the requirements for you; you do not have to speak to your German health insurer.

Can I pay for the treatment in instalments as a self-paying patient?

Yes, part payment is possible via our partner medipay. Prices for Weight Doctors® REVISION start at €900; more under Payment in instalments.

Where does the treatment take place?

The clinic is available in person, by telephone or by video. Surgical procedures take place at the Weight Doctors® Nationalklinik in Wertheim.

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Losing weight without medication: lowering the hunger hormone endoscopically – no surgery, no incisions. On its own or combined with an endo sleeve.

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A temporary companion for 6 or 12 months – also swallowable, with no endoscopy at all.

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Gastric bypass or gastric sleeve surgery for higher BMIs, incl. private medical preliminary examination and aftercare.

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Corrective procedure after weight-loss surgery

Corrective procedure when earlier weight-loss surgery has not brought the desired success.

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