This is a very controversial topic. Some centers reported an increased incidents of Gastroesophageal Reflux Disease (GERD) after gastric sleeve surgery. However, other reports showed decreased incidents of GERD. Overall, the heart burn after gastric sleeve can usually be managed with antacid medications and lifestyle changes. Very rarely will surgeons have to convert the gastric sleeve to the Roux-en-Y gastric bypass surgery to treat the reflux (less than 1% in most reported series).