Esophageal Motility and Reflux Symptoms Before and After Bariatric Surgery

Korenkov, Michael; Köhler, L.; Yücel, Nedim; Grass, Guido; Sauerland, Stefan; Lempa, M.; Troidl, H.

doi:10.1381/096089202321144621

Cited by 90 publications

(73 citation statements)

References 17 publications

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“…It has become apparent that esophageal dilatation is not as prevalent in this patient population as previously reported [24]. In addition, a recent report reveals a low incidence of primary esophageal motility disorders (2%) in morbidly obese patients [16], strengthening the argument that it is not a necessary routine preoperative test.…”

Section: Discussionmentioning

confidence: 55%

Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding

et al. 2006

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Section: Discussionmentioning

confidence: 55%

Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding

et al. 2006

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“…These varied results of weight loss on GERD symptoms could be because of small sample size, gender differences, wide variation in BMI of subjects (23 vs. 43), and use of different weight loss methods (various lifestyle changes vs. surgical approaches) (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Furthermore, a number of lifestyle intervention treatments have been attempted for GERD-low calorie diet, use of fruits/ vegetables, and physical activity; individually each intervention has no direct correlation with GERD improvement as shown in previous population-based studies (13,22,23) and a recent meta-analysis (32).…”

Section: Discussionmentioning

confidence: 99%

“…Previous data on the impact of weight loss achieved through various lifestyle (dietary changes and physical activity) (21)(22)(23)(24)(25) or surgical methods (Roux-en-Y gastric bypass or vertical band gastroplasty) (26)(27)(28)(29)(30) on GERD symptoms are scarce and with conflicting results (31). A systematic review evaluating the effects of various life style changes on GERD symptoms suggested that weight loss and head of bed elevation could improve symptoms of GERD (32).…”

Section: Introductionmentioning

confidence: 99%

Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial

Singh¹,

Lee²,

Gupta³

et al. 2012

Obesity

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Objective-Weight gain is an important risk factor for gastroesophageal reflux disease (GERD); however, whether weight loss can lead to resolution of GERD symptoms is not clear. Our aim was to measure the impact of weight loss on GERD symptoms.Design and Methods-In a prospective cohort study at a tertiary referral center, overweight/ obese subjects (BMI 25-39.9 kg/m2) were enrolled in a structured weight loss program. Weight loss strategies included dietary modifications, increased physical activity and behavioral changes. At baseline and at 6 months, BMI and waist circumference were measured and all participants completed a validated reflux disease questionnaire.Results-A total of 332 adult subjects, mean age 46 years and 66% women were prospectively enrolled. At baseline, the mean body weight, BMI, and waist circumference were 101 (±18) kg, 35 (±5) kg/m2 and 103 (±13) cm. At 6 months, majority of the subjects (97%) lost weight (average weight loss: 13 ± 7.7 kg) and as compared with baseline, there was a significant decrease in the overall prevalence of GERD (15 vs. 37%; P < 0.01) and the mean GERD symptom score (1.8 vs. 5.5; P < 0.01). Overall, 81% of the subjects had reduction in GERD symptom scores; 65% had complete resolution and 15% had partial resolution of reflux symptoms. There was a significant correlation between % body weight loss and reduction in GERD symptom scores (r = 0.17, P < 0.05).Conclusions-In conclusion, the overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects.

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“…In only six of 814 patients (0.9%), as reported by Ghassemian et al, X-ray examination of the GI tract demonstrated relevant abnormality, and not a single operation had to be delayed due to the results of the GI tract series (EL 4 [122]). Using esophageal manometry, two recent case series found abnormalities in only 13 to 20% of patients and being without clinical consequences (EL 4 [169,186]). Jaffin et al, however, described that esophageal disorders were highly prevalent (61%) and associated with postoperative results (EL 4 [150]).…”

Section: Preoperative Diagnosticsmentioning

confidence: 99%

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

Sauerland

Angrisani

Belachew³

et al. 2004

Surg Endosc

450

280

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After the patient's multidisciplinary evaluation, obesity surgery should be considered in adults with a documented BMI greater than or equal to 35 and related comorbidity, or a BMI of at least 40. In addition to standard laboratory testing, chest radiography, electrocardiography, spirometry, and abdominal ultrasonography, the preoperative evaluation of obesity surgery patients also includes upper gastrointestinal endoscopy or radiologic evaluation with a barium meal. Psychiatric consultation and polysomnography can safely be restricted to patients with clinical symptoms on preoperative screening. Adjustable gastric banding (GB), vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure therefore should be tailored to the individual situation. There is evidence that a laparoscopic approach is advantageous for LAGB, VBG, and GB (and probably also for BPD). Antibiotic and antithromboembolic prophylaxis should be used routinely. Patients should be seen 3 to 8 times during the first postoperative year, 1 to 4 times during the second year and once or twice a year thereafter. Outcome assessment after surgery should include weight loss and maintainance, nutritional status, comorbidities and quality-of-life.

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Esophageal Motility and Reflux Symptoms Before and After Bariatric Surgery

Abstract: The present results do not show any effect of gastric reduction surgery on postoperative esophageal function or gastroesophageal reflux symptoms.

Cited by 90 publications

References 17 publications

Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding

Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding

Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial

Obesity surgery: Evidence-based guidelines of the European Association for Endoscopic Surgery (EAES)

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