Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-band system implantation

Iovino, Paola; Angrisani, Luigi; Tremolaterra, F.; Nirchio, E.; Ciannella, M.; Borrelli, Vincenzo; Sabbatini, F; Mazzacca, G; Ciacci, Carolina

doi:10.1007/s00464-001-9225-0

Cited by 79 publications

(80 citation statements)

References 11 publications

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“…When compared to healthy asymptomatic control subjects, 43 consecutive severely obese patients were found to have a lower LESP (11.9 ± 5.3 mmHg vs 15.9 ± 2.7 mmHg), and 51% were noted to have abnormal acid exposure [16] . Similarly, in a large cohort of patients with foregut symptoms, the prevalence of a mechanically defective LES (based on hypotensive LES, total length, or abdominal length) increased as BMI increased, with 55% of obese patients demonstrating a defective LES [17] .…”

Section: Pathophysiologymentioning

confidence: 92%

“…The effects of LAGB on GERD are conflicting, however, with some studies demonstrating improvement in physiological GERD metrics [16] , while others show improvement on GERD questionnaires and/or through the discontinuation of GERD medications [50,51] . In contrast, several studies have demonstrated measured exacerbation of esophageal acid exposure, GERD symptoms, and the development or worsening of esophageal dysmotility following LAGB [52][53][54] .…”

Section: Lagb and Gerdmentioning

confidence: 99%

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Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery?

Prachand

Alverdy²

2010

WJG

108

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Increases in the prevalence of obesity and gastroesophageal reflux disease (GERD) have paralleled one another over the past decade, which suggests the possibility of a linkage between these two processes. In both instances, surgical therapy is recognized as the most effective treatment for severe, refractory disease. Current surgical therapies for severe obesity include (in descending frequency) Roux-en-Y gastric bypass, adjustable gastric banding, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, while fundoplication remains the mainstay for the treatment of severe GERD. In several large series, however, the outcomes and durability of fundoplication in the setting of severe obesity are not as good as those in patients who are not severely obese. As such, bariatric surgery has been suggested as a potential alternative treatment for these patients. This article reviews current concepts in the putative pathophysiological mechanisms by which obesity contributes to gastroesophageal reflux and their implications with regards to surgical therapy for GERD in the setting of severe obesity. 2 ) in a recent estimate [2] . BMI itself is a strong predictor of overall mortality, with a progressive excess in mortality noted above the optimum BMI of 22.5-25 kg/m 2 , due mainly to metabolic and vascular disease [3]

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Section: Pathophysiologymentioning

confidence: 92%

Section: Lagb and Gerdmentioning

confidence: 99%

Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery?

Prachand

Alverdy²

2010

WJG

108

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“…If medically indicated and if such a patient is willing, further bariatric surgery should be considered (EL B, C, D [229][230][231][232][233][234][235][236][237][238][239][240][241][242] ).…”

Section: Failed Treatmentmentioning

confidence: 99%

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

et al. 2013

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In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity -European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.

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“…Whereas some studies report no differences between obese patients and a normal population [19][20][21][22], others have found a significantly lower LES pressure in obese patients [23,24]. However, most of these studies report LES pressure almost exclusively.…”

Section: Discussionmentioning

confidence: 83%

Upper gastrointestinal investigations before gastric banding

et al. 2009

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Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-band system implantation

Abstract: There is a high prevalence of GERD in the obese population. Uncomplicated LAGB placement reduces the amount of acid in these patients with abnormal esophageal acid exposure.

Cited by 79 publications

References 11 publications

Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery?

Gastroesophageal reflux disease and severe obesity: Fundoplication or bariatric surgery?

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

Upper gastrointestinal investigations before gastric banding

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