Table 5.

Proposed mechanisms for de novo or increased gastroesophageal reflux following bariatric surgery.

Proposed Mechanisms for De Novo or Increased Gastroesophageal Reflux following Bariatric Surgery
Sleeve Gastrectomy	Roux-en-Y Gastric Bypass
Loss of the antireflux barrier ○Disruption of the esophagogastric junction, gastroesophageal flap valve, the angle of His, gastric sling fibers, fundal resection Functional impairment of the gastroesophageal junction ○Baseline hiatal hernia Increased intragastric pressure ○Narrow sleeve dimensions ○Sleeve stenosis, angulation or kinking ○Incorporation of the antrum into the sleeve resection ○Overfilling of sleeve due to a large meal size Sleeve leak	Functional impairment of the gastroesophageal junction ○Baseline hiatal hernia Anastomotic stenosis Large gastric remnant Gastrogastric fistula