Approximately 1 in 5 people in the United States suffers from GERD, which refers to repeatedly experiencing symptoms of acid reflux, interfering with your day-to-day life.

 Common symptoms of GERD

  • Burning sensation in your chest
  • Food coming back up into your mouth
  • Bitter/acid taste in your mouth


For further information on GERD symptoms visit Are You Regaining Weight by Feeding your Reflux?

It is common for people with bariatric surgery and acid reflux to develop anemia, yet it’s important to differentiate anemia from malabsorptive surgeries like the Duodenal Switch (DS) or the Gastric bypass and anemia from restrictive surgeries like the gastric sleeve, we will be focusing on the latter. Patients who undergo a malabsorptive procedure may experience anemia due to precisely the lack of nutrient absorption inherent to the surgery they had done whereas gastric sleeve surgery patients may experience anemia due to a combination of elements.

There are multiple factors that might play a role in the development of anemia:

  • Given that a large portion of your stomach has been removed during the gastric sleeve surgery, you’re not producing adequate quantities of what is called the intrinsic factor, this is a protein that is produced in the stomach that helps absorb vitamin B12, and without proper amounts of it, you can’t produce red blood cells properly.
  • With acid reflux, not only your stomach is exposed to the acid, but your intestines and esophagus as well, this causes microtears and light bleeding every day. This bleeding isn’t enough to turn into something more serious like an ulcer, yet you’re losing red blood cells on the daily, ergo iron.
  • Patients tend to eat to calm their symptoms from acid reflux, however, it’s not very often they’re consuming all the nutrients they need. They tend to eat focusing on easing acid reflux symptoms and not focusing on nutrition which may lead to a deficiency in iron-rich foods.
  • Acid reflux medication (like pantoprazole or omeprazole) also affects one’s system in the long run, as these don’t allow the proper absorption of micronutrients like calcium, zinc, and iron.

Now, having acid reflux doesn’t inherently mean you’ll have anemia, nevertheless, in our experience, it happens as a snowball effect, and patients more often than not develop it. According to Mayo Clinic (2019), anemia frequently goes overlooked in its early stages, however as it progresses symptoms escalate.

Symptoms of anemia

  • Fatigue or extreme tiredness
  • Pale skin
  • Shortness of breath, heart palpitations, or chest pain
  • Headaches or feeling lightheaded
  • Tinnitus (ringing in your head)
  • Craving odd substances

What can I do to prevent it?

If you suffer from consistent acid reflux or GERD, you should check with your doctor for the best treatment for you. We recommend a blood chemistry panel making sure it includes vitamin B12 and iron and an endoscopy to diagnose your situation. Your doctor may recommend iron infusions, B12 and/or iron shots, additional oral supplementation, etc. At Mexicali Bariatric Center we recommend getting blood work done 3 times in your first-year post surgery, and at least once a year after that to detect any possible deficiencies.

If the problem persists you may have to convert to a gastric bypass. For more information on how the gastric bypass may help resolve acid reflux issues after a gastric sleeve  you may refer to this blog post: RNY Gastric Bypass as a solution for GERD after weight loss surgery


Mayo Clinic Staff. (2019). Iron deficiency anemia. https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Mayo Clinic Staff. (2020). Heartburn. https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223

National Health Service. (2021). Iron deficiency anemia. https://www.nhs.uk/conditions/iron-deficiency-anaemia/