Surgical management of gastroesophageal reflux disease in the obese patient

Nau, Peter; Jackson, Hope T.; Aryaie, Amir; Ibele, Anna; Shouhed, Daniel; Menzo, Emanuele Lo; Kurian, Marina; Khaitan, Leena

doi:10.1007/s00464-019-07231-w

Cited by 21 publications

(11 citation statements)

References 68 publications

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“…Almost all the patients were prescribed statin therapy and some of them showed gastroesophageal reflux disease (GERD) as a side effect of medication as it is linked to higher probabilities of being detected with esophagitis and gastroesophageal reflux disease [62]. In addition to this, obesity has also been linked with increased symptoms of GERD and requires special attention in cardiac obese patients [63].…”

Section: Discussionmentioning

confidence: 99%

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Ali

Al-Alawi

Sadiq

et al. 2020

J. Pharm. Nutr. Sci.

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Objective: To assess the role of various dietary and lifestyle modifications in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients.Methods: Seventy-two patients, from the outpatient cardiology clinic of Sultan Qaboos University Hospital, were included in the study after obtaining an informed consent. In a questionnaire-based study, we collected data about four lifestyle modifications; physical activity, weight reduction, dietary intake and healthy eating patterns and smoking or non-smoking status, in personal interviews. A modified previously validated study questionnaire, which comprised of a semi-quantitative food frequency questionnaire, was used to assess the demographic information, eating patterns, diet quality index score, and daily dietary intake of study participants. The data about patient’s baseline characteristics, revascularization information and biochemical laboratory tests was harvested from the SQUH’s electronic record system. The statistical analysis of data was made using R-studio v.7 and Microsoft excel v.7.Results: The males had higher educational level as compared to females and were more active than females. The data indicated that 16% males and females were diabetic, 10% males and 21% females were hypertensive, and 30% males and 42% females had both diabetes and hypertension. Forty eight percent males and 63% females had body mass index (BMI) >30. However, no significant (P < 0.05) differences were observed in the BMI, diabetes and hypertension status in males and females. Both genders had poor nutritional knowledge. Although the LDL-C and HDL-C values in males and females differed, they were within the normal therapeutic limits. The HbA1c and C-reactive protein values were above the normal ranges with no significant (P < 0.05) difference in both males and females. The average daily energy intake in males (2694 kcalories) was significantly higher compared to females (1603 kcalories). The proportionate contribution of energy from macronutrients was within the acceptable macronutrient distribution ranges. Omani diet score for males (75.5) and females (74.6) didn’t differ significantly (P < 0.05), indicating their adherence to healthy dietary patterns.Conclusions: The results suggest that dietary and lifestyle modifications play significant role in the secondary prevention of biomarkers of plaque recurrence in Omani coronary revascularized patients. Behavioral counseling to promote healthy modifications in dietary and lifestyle factors are therefore recommended in the secondary prevention of risk of plaque recurrence.

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Section: Discussionmentioning

confidence: 99%

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Ali

Al-Alawi

Sadiq

et al. 2020

J. Pharm. Nutr. Sci.

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“…Gastric emptying in the pouch is accelerated compared to an intact stomach, further contributing to the decrease in esophageal acid exposure. Finally, bile reflux is prevented by the post-RYGB gastrointestinal anatomy [42].…”

Section: Treatment Of Gerd In Patients With Excess Body Weightmentioning

confidence: 99%

“…Against this background, it is not surprising that the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recommends RYGB as the gold-standard surgical treatment in a population with GERD and excess body weight (BMI > 35) [42]. The German guidelines from 2014 did not yet consider RYGB for surgical treatment of this patient population [44].…”

Section: Treatment Of Gerd In Patients With Excess Body Weightmentioning

confidence: 99%

“…A recently published systematic review and meta-analysis appraising the prevalence of GERD, esophagitis, and BE after LSG demonstrated de novo reflux in 23%, esophagitis in 30%, and BE in 8% of patients postoperatively [50]. Considering all of these data, LSG is not recommended for the treatment of GERD in patients with excess body weight and obviously seems to be an inferior option in this population [42].…”

Section: Treatment Of Gerd In Patients With Excess Body Weightmentioning

confidence: 99%

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Excess Body Weight and Gastroesophageal Reflux Disease

Thalheimer

Bueter

2021

Visc Med

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Background: Gastroesophageal reflux disease (GERD) is strongly associated with excess body weight. Summary: GERD is characterized by typical symptoms with or without mucosal damage because of retrograde flow of gastric content into the esophagus. An ineffective esophagogastric junction (EGJ) combined with anatomical abnormalities is considered to be causative. The incidence of GERD is strongly associated with excess body weight, reflecting the pathophysiological relevance of the abdominothoracic pressure gradient. Key Message: Weight loss has been demonstrated to be an effective therapy for GERD combined with obesity. In cases in which surgical therapy is indicated, traditional antireflux surgery has led to equivocal results, advocating a proximal Roux-en-Y gastric bypass in these patients to correct both GERD and excess body weight.

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“…The objective data on clinical symptoms, monitoring, and need of medical therapy, indicate that when compared to RYGB, SG outcomes provide insignificant improvement in the presence of GERD (59).…”

Section: Surgicalmentioning

confidence: 99%

De novo gastroesophageal reflux disease esophageal surgery in bariatrics: a literature review and analysis of the current treatment options

Alemán¹,

Menzo²,

Szomstein³

et al. 2021

Ann Transl Med

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With the exponential increase of worldwide obesity, the number of bariatric surgery (BaS) procedures have equally risen. The surgical management of obesity has been widely established as the standard of care for sustained weight reduction, resolution, and improvement of associated comorbidities. However, BaS itself can have postoperative deleterious effects, including de novo gastroesophageal reflux disease (GERD) and upper gastrointestinal motility disorders. The modified anatomy resulting from BaS, due to either a restrictive or hypoabsorptive component, gives this disorder a multifactorial etiology.The overall management of de novo GERD should focus on three primordial approaches: Non-surgical, endoluminal, and surgical. Even in the absence of de novo GERD following primary or secondary BaS, said disorder should be closely monitored and therapy should be catered in a case-by-case approach.Consequently, treatment strategies have been developed on this principle as to adequately resolve de novo GERD. Despite the presence of multiple and suitable treatment modalities, the operating surgeon should perform them in the best interest of the patient. Short-, medium-, and long-term outcomes should be taken into consideration prior to proceed with any type of preferred management option. This article herein presents an update on the surgical management of de novo GERD following BaS and current practical innovations.

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Surgical management of gastroesophageal reflux disease in the obese patient

Cited by 21 publications

References 68 publications

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Role of Dietary and Lifestyle Modifications in the Secondary Prevention of Biomarkers of Plaque recurrence in Omani Coronary Revascularized Patients

Excess Body Weight and Gastroesophageal Reflux Disease

De novo gastroesophageal reflux disease esophageal surgery in bariatrics: a literature review and analysis of the current treatment options

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