Erosive Esophagitis after Bariatric Surgery: Banded Vertical Gastrectomy versus Banded Roux-en-Y Gastric Bypass

Miguel, Gustavo Peixoto Soares; Azevedo, João Luiz Moreira Coutinho; Souza, Paulo Henrique Oliveira de; Neto, João de Siqueira; Mustafa, Felipe; Zambrana, Évelyn Saiter; Carvalho, Perseu Seixas de

doi:10.1007/s11695-010-0321-x

Cited by 21 publications

(4 citation statements)

References 32 publications

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“…Gastric bypass was effective in the control of reflux esophagitis, being quite evident the regression in cases of moderate and severe esophagitis. An important improvement in GERD after bariatric treatment with the gastric bypass technique has been reported [13][14][15] , and the main mechanisms described to justify such improvement are the fact that the gastric pouch is small and has a lower acid production; weight loss leads to lower intra-abdominal pressure; and intestinal derivation improves biliary reflux. In this sample, no correlation was demonstrated between BMI -both preoperatively and postoperatively -and the degree of esophagitis.…”

Section: Discussionmentioning

confidence: 99%

Effect of Roux-en-Y gastric bypass in the control of erosive esophagitis

et al. 2019

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Introduction: Gastroesophageal reflux disease (GERD) is a multifactorial disease associated with environmental and genetic factors. Obesity is among the risk factors for its development, which also correlates with an increase in severity of clinical presentation and a higher incidence of complications associated with reflux. Methods: This historical cohort study included a sample of 249 patients who had undergone bariatric surgery using the Roux-en-Y gastric bypass technique at the Hospital São Vicente de Paulo, Passo Fundo, southern Brazil, from January 2014 to December 2015. Results: Of 249 patients, 77.9% (190 patients) were female and the mean age was 38 years. The occurrence of reflux esophagitis was 81.1% (196 patients) in the preoperative period and 31.3% (75 patients) in the postoperative period. With regard to bariatric treatment response to control moderate and severe esophagitis (grades B, C and D), there was a reduction in prevalence from 62 (25%) to 12 (5%) patients (p<0.05). Conclusions: Bariatric surgery using the Roux-en-Y gastric bypass technique is effective in the control of reflux esophagitis. Regression is observed mainly in cases of moderate and severe esophagitis.

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Section: Discussionmentioning

confidence: 99%

Effect of Roux-en-Y gastric bypass in the control of erosive esophagitis

et al. 2019

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“…Besides, a worsening of endoscopic esophagitis and GER have been demonstrated after sleeve [22]. Himpens [23] reported 21 % of new gastroesophageal reflux complaints 6 years after sleeve, and Miguel [24] reported 45 % of patients with erosive esophagitis after sleeve. In spite of this, some authors suggest that the improvement of GER after sleeve can be explained by the postoperative weight loss, but it could also be related to the increase of the gastric compliance and accelerated gastric emptying [22,25].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Barrett’s Esophagus in Bariatric Patients Undergoing Sleeve Gastrectomy

2015

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“… 70 Likewise, the gastric sleeve resection increases the prevalence of oesophagitis from 18% to 45%. 71 The only bariatric procedure that reduces reflux and reflux symptoms is the gastric bypass procedure with Roux-en-Y reconstruction. 72 Some practitioners go as far as to recommend this procedure for the treatment of GORD in morbidly obese patients.…”

Section: Management Of Symptomatic Refluxmentioning

confidence: 99%

Republished: Symptomatic reflux disease: the present, the past and the future

Boeckxstaens

El–Serag

Smout

et al. 2015

Postgraduate Medical Journal

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The worldwide incidence of GORD and its complications is increasing along with the exponentially increasing problem of obesity. Of particular concern is the relationship between central adiposity and GORD complications, including oesophageal adenocarcinoma. Driven by progressive insight into the epidemiology and pathophysiology of GORD, the earlier belief that increased gastroesophageal reflux mainly results from one dominant mechanism has been replaced by acceptance that GORD is multifactorial. Instigating factors, such as obesity, age, genetics, pregnancy and trauma may all contribute to mechanical impairment of the oesophagogastric junction resulting in pathological reflux and accompanying syndromes. Progression of the disease by exacerbating and perpetuating factors such as obesity, neuromuscular dysfunction and oesophageal fibrosis ultimately lead to development of an overt hiatal hernia. The latter is now accepted as a central player, impacting on most mechanisms underlying gastroesophageal reflux (low sphincter pressure, transient lower oesophageal sphincter relaxation, oesophageal clearance and acid pocket position), explaining its association with more severe disease and mucosal damage. Since the introduction of proton pump inhibitors (PPI), clinical management of GORD has markedly changed, shifting the therapeutic challenge from mucosal healing to reduction of PPI-resistant symptoms. In parallel, it became clear that reflux symptoms may result from weakly acidic or non-acid reflux, insight that has triggered the search for new compounds or minimally invasive procedures to reduce all types of reflux. In summary, our view on GORD has evolved enormously compared to that of the past, and without doubt will impact on how to deal with GORD in the future.

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Erosive Esophagitis after Bariatric Surgery: Banded Vertical Gastrectomy versus Banded Roux-en-Y Gastric Bypass

Abstract: After 1 year of follow-up, we observed a worsening evolution of EE in the SRSG group, but improvement in the SRGB group.

Cited by 21 publications

References 32 publications

Effect of Roux-en-Y gastric bypass in the control of erosive esophagitis

Effect of Roux-en-Y gastric bypass in the control of erosive esophagitis

Prevalence of Barrett’s Esophagus in Bariatric Patients Undergoing Sleeve Gastrectomy

Republished: Symptomatic reflux disease: the present, the past and the future

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