Endoscopic Changes Related to Gastroesophageal Reflux Disease: Comparative Study Among Bariatric Surgery Patients

Abstract

Background : Obesity is correlated with several comorbidities, including gastroesophageal reflux disease. Its main complications are detectable by endoscopy: erosive esophagitis and Barrett's esophagus. Aim: To correlate erosive esophagitis and hiatal hernia with the degree of body mass index (BMI). Method: Was performed a retrospective analysis of 717 preoperative endoscopic reports of bariatric patients. Fifty-six (8%) presented hiatal hernia, being 44 small, nine medium and five large. Esophagitis was classified by Los Angeles classification. Results: There was no correlation between the presence and dimension of hiatal hernia with BMI. One hundred thirty-four (18.7%) patients presented erosive esophagitis. Among them, 104 (14.5%) had esophagitis grade A; 25 (3.5%) grade B; and five (0.7%) grade C. When considering only the patients with erosive esophagitis, 77.6% had esophagitis grade A, 18.7% grade B and 3.7% grade C. Were identified only two patients with Barrett's esophagus (0,28%).Conclusion: There was a positive correlation between the degree of esophagitis with increasing BMI.

Prevalence of gastroesophageal reflux disease in obese patients eligible for bariatric surgery

“…The prevalence of ERE in this same study was 18.7%, which was higher than that in the general population but lower than that in our sample (38.0%). 21 Similar to other studies, 5,21,27 our results showed a significant relationship (p=0.011) between BMI >35kg/m 2 and ERE. Furthermore, there was a significant correlation between ERE and the DeMeester score (p=0.028), and between ERE and transient LES relaxation (p=0.010), and the variables were strongly and positively correlated and varied simultaneously.…”

“…These results are consistent with our study. 12,13,21,22 The prevalence of ERE in the study population was significantly higher (38.0%) than that of the general population (11.8-15.5%), 23,24 and the prevalence of ERE in symptomatic patients (54.0%) and asymptomatic patients (46.0%) was significantly higher than that in the general population (24.5% and 36.8%, respectively). 25 The sensitivity of UGE (48.4%) was similar to that reported in the literature for the general population; however, the specificity was lower in our study (69.8%).…”

Fundoplication Conversion in Roux-en-Y Gastric Bypass for Control of Obesity and Gastroesophageal Reflux: Systematic Review

“…Bariatric revision procedures are more complex 18 , 26 , with fundoplication for GB being the group of higher risk when compared to the gastric band for vertical gastrectomy and gastric band for GB 21 . This in patients with anterior fundoplication has more technical difficulties, longer operative time and postoperative morbidity, both early and late period 9 , 21 . The technical difficulty of the revisional GB was well reported in the case-control study of Ibele et al 12 .…”

Sleeve Gastrectomy and Fundoplication as a Single Procedure in Patients With Obesity and Gastroesophageal Reflux

“…There has been a trend in favor of laparoscopic sleeve gastrectomy (LSG), which represents about 70% of the bariatric procedures. In recent times this surgery was most commonly performed in patients with body mass index (BMI) under 35 1 , 37 . These patients are an excellent group to perform this procedure 33 ; however, there is no consensus about its effects when patients suffer from gastroesophageal reflux disease (GERD).…”