Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Dietz, Judite; Ulbrich-Kulcynski, Jane Maria; Souto, Kátia Elisabete Pires; Meinhardt, Nelson Guardiola

doi:10.1590/s0004-28032012000100009

Cited by 29 publications

(19 citation statements)

References 34 publications

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“…A systematic review has shown that the prevalence of H. pylori in obese patients scheduled to undergo bariatric surgery varies from 6.9-61.3%. The prevalence of infection caused by this pathogen varies from 30 to 90% around an average of 60% 7 .…”

Section: Discussionmentioning

confidence: 99%

“…H. pylori infection causes inflammation of the gastric mucosa and may lead to problems such as intestinal metaplasia and even cancer. Its eradication may revert this inflammatory process but this is not possible in more advanced phases 7 .…”

Section: Discussionmentioning

confidence: 99%

“…H. pylori is already known to be a carcinogenic agent, which operates by way of chronic gastritis or intestinal metaplasia. These changes in the stomach undergoing RYGB surgery may be harmful, because of the existence of the excluded stomach, leading to serious complications, if abnormalities are not identified prior to the procedure 6 , 7 .…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory Disorders Associated With Helicobacter Pylori in the Roux-en-Y Bypass Gastric Pouch

Chaves

Borges

Souza

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: The prevalence of Helicobacter pylori in obese candidates for bariatric surgery and its role in the emergence of inflammatory lesions after surgery has not been well established. Aim: To identify the incidence of inflammatory lesions in the stomach after bariatric surgery and to correlate it with H. pylori infection. Methods: This is a prospective study with 216 patients undergoing Roux-en-Y gastric bypass. These patients underwent histopathological endoscopy to detect H. pylori prior to surgery. Positive cases were treated with antibiotics and a proton inhibitor pump followed by endoscopic follow-up in the 6th and 12th month after surgery. Results: Most patients were female (68.1%), with grade III obesity (92.4%). Preoperative endoscopy revealed gastritis in 96.8%, with H. pylori infection in 40.7% (88/216). A biopsy was carried out in 151 patients, revealing H. pylori in 60/151, related to signs of inflammation in 90% (54/60). In the 6th and 12th month after surgery, the endoscopy and the histopathological exam showed a normal gastric pouch in 84% of patients and the incidence of H. pylori was 11% and 16%, respectively. The presence of inflammation was related to H. pylori infection (p<0,001). Conclusion:H. pylori has a similar prevalence in both obese patients scheduled to undergo bariatric surgery and the general population. There is a low incidence of it in the 6th and 12th months after surgery, probably owing to its eradication when detected prior to surgery. When inflammatory disease is present in the new gastric reservoir it is directly related to H. pylori infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inflammatory Disorders Associated With Helicobacter Pylori in the Roux-en-Y Bypass Gastric Pouch

Chaves

Borges

Souza

et al. 2016

ABCD, arq. bras. cir. dig.

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“…Many guidelines recommend routine endoscopy but many of Numbers in brackets are the 95 % confidence intervals these were published prior to sleeve gastrectomy becoming an established bariatric procedure [15]. Furthermore, it has previously been demonstrated that pre-operative gastroscopy findings do not correlate well with histopathologic findings and would uncommonly alter the surgical management when a sleeve gastrectomy is intended [7,16,17]. As sleeve gastrectomy does not make duodenal access more difficult and does not leave an in situ gastric remnant, the argument for routine pre-operative gastroscopy for sleeve gastrectomy is less strong than for gastric bypass.…”

Section: Discussionmentioning

confidence: 99%

What Does the Excised Stomach from Sleeve Gastrectomy Tell us?

et al. 2015

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“…A high prevelance of lower esophageal sphincter (LES) incompetency and hiatal hernia secondary to increased intraabdominal pressure frequently leads to GERD symptoms in obese persons (7). Despite the many studies in the lit-erature, the relationship between obesity and gastroesophageal sphincter incompetency (GSI) and H. pylori infection has not been fully clarified (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

The importance of upper gastrointestinal endoscopy in morbidly obese patients

Baysal¹,

Kayar²,

Danalıoğlu³

et al. 2015

Turk J Gastroenterol

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Background/Aims: Obesity is an epidemic and its prevelance and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevelance of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients. Materials and Methods: An upper gastrointestinal system endoscopy and mucosal sampling were performed in all patients hospitalized for bariatric surgery. Age, gender, BMI, co-morbidities and endoscopic findings were recorded. Gastroesophageal sphincter incompetency was classified according to Hill classification. The patients were divided into two groups: group I, endoscopically normal and group II, endoscopically abnormal. Results: Total 127 patients were enrolled into prospective study. Of these, 93 (%73.2) were female and the mean age was 38.9±12.5 years (range: 16-68). Abnormal endoscopic findings and H. pylori were detected in 80.4% and 44.9% of patients, respectively. In group II, patients were older, BMI higher and H. pylori more prevalent (all statistically significant). Diabetes mellitus, hypertension and dyslipidemia were the most frequent common co-morbidities. Rate of multiple co-morbidities were more common in group II. Gastroesophageal sphincter incompetency in total group was observed in a rate of 46.5% and was weakly correlated with BMI. Conclusion: Four-fifths of obese patients have at least one endoscopic abnormal finding, three fourth at least one co-morbidity and half H. pylori positivity. Upper gastrointestinal system endoscopy should be performed routinely in all patients to predict and prevent complications following bariatric surgery.

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Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Abstract: -Context -The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach.

Cited by 29 publications

References 34 publications

Inflammatory Disorders Associated With Helicobacter Pylori in the Roux-en-Y Bypass Gastric Pouch

Inflammatory Disorders Associated With Helicobacter Pylori in the Roux-en-Y Bypass Gastric Pouch

What Does the Excised Stomach from Sleeve Gastrectomy Tell us?

The importance of upper gastrointestinal endoscopy in morbidly obese patients

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