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Introduction: An unbeffered postprandial proximal gastric acid pocket (PPGAP) has been demonstrated in normal individuals and patients with gastroesophageal reflux disease (GERD). The role of gastric anatomy in the physiology of the PPGAP remains unclear. It is also unclear whether operations that control GERD, such as Roux-en-Y gastric bypass (RYGB) and Nissen fundoplication, change the PPGAP. Aims: This study aims to analyze the presence of PPGAP in patients submitted to RYGB. Methods: Nine patients who had a RYGB for morbid obesity (mean age 54 years, 8 females, mean time from operation 5 years) were studied. All patients were free of foregut symptoms. Patients underwent a high resolution manometry to identify the location of the lower border of the lower esophageal sphincter (LBLES). A station pull-through pH-monitoring was performed from 5 cm below the LBLES to the LBLES in increments of 1cm in a fasting state and 10 minutes after a standardized fatty meal (40g of chocolate, 50% fat).Results: Acid was not detected in the stomach of 1 patient. In 4 patients acid was detected in the whole studied gastric pouch, a buffered layer was not found. In 2 patients PPGAP was not detected. In 2 patients a PPGAP was noted with an extension of 1 and 2 cm. Conclusion: PPGAP is present in a minority of patients after RYGB, this finding may explain part of the GERD control after RYGB and that the gastric fundus may play a role in the genesis of the PPGAP.