The Impact of Gastric Bypass on Gastroesophageal Reflux Disease in Morbidly Obese Patients.

Abstract

OBJECTIVE:

To assess the impact of Roux-en-Y gastric bypass (GBP) on gastroesophageal reflux disease (GERD) in morbidly obese patients.

BACKGROUND:

Recently, authors have reported that early results of GBP can control GERD. However, longer follow-ups based on objective parameters for GERD are missing.

METHODS:

Fifty-three patients [15 men (28%), 39 years old (range, 18-59), body mass index = 46 ± 7.7 kg/m2] were consecutively evaluated for GERD irrespectively of related symptoms, before the operation (E1) and at 6 (E2) and 39 ± 7 months postoperatively (E3). The end points were (1) esophageal syndromes based on the Montreal Consensus and (2) an esophageal acid exposure assessment.

RESULTS:

Body mass index dropped from 46 ± 7.7 kg/m2 at E1 to 30 ± 5.2 kg/m2 at E3. Typical reflux syndrome displayed a significant decrease from 31 (58%) at E1 to 8 (15%) at E2 and 5 (9%) at E3. Statistically significant differences occurred between E1 and both postoperative evaluations (P < 0.001). Reflux esophagitis was detected in 24 (45%), 17 (32%), and 10 patients (19%) at E1, E2, and E3, respectively (P = 0.002). The incidence of GERD decreased in 34 (64%) and 21 (40%) patients at E1 and E2, respectively, and then in 12 (23%) patients at E3. DeMeester scores reduced from 28.6 (E1) to 9.4 (E2) and 1.2 (E3) (P < 0.001).

CONCLUSIONS:

For most morbidly obese patients, in addition to causing significant weight loss, GBP reduces GERD symptoms, improves reflux esophagitis, and decreases esophageal acid exposure for longer than 3 years.

• Authors: Carlos Augusto S Madalosso, Richard Ricachenevsky Gurski, Sidia M Callegari-Jacques, Daniel Navarini, Guilherme Mazzini, Marina da Silva Pereira
• Journal: Annals of surgery (Ann Surg) Vol. 263 Issue 1 Pg. 110-6 (Jan 2016) ISSN: 1528-1140 [Electronic] United States
• PMID: 25607766 (Publication Type: Clinical Study, Journal Article)

Topics

• Adolescent
• Adult
• Female
• Gastric Bypass
• Gastroesophageal Reflux (complications)
• Humans
• Male
• Middle Aged
• Obesity, Morbid (complications, surgery)
• Prospective Studies
• Young Adult