Obesity and GERD: Pathophysiology and Effect of Bariatric Surgery |
| |
Authors: | Radu Tutuian |
| |
Institution: | Division of Gastroenterology, University Clinics of Visceral Surgery and Medicine, Bern University Hospital, Inselspital Bern, Bern, Switzerland. radu.tutuian@insel.ch |
| |
Abstract: | Epidemiologic, endoscopic, and pathophysiologic studies document the relationship between obesity and gastroesophageal reflux
disease (GERD). Increased body mass index and accumulation of visceral fat are associated with a two- to threefold increased
risk of developing reflux symptoms and esophageal lesions. Given this association, many studies were designed to evaluate
the outcome of reflux symptoms following conventional and surgical treatment of obesity. Among bariatric procedures, gastric
sleeve and banded gastroplasty were shown to have no effect or even worsen reflux symptoms in the postoperative setting. Gastric
banding improves reflux symptoms and findings (endoscopic and pH-measured distal esophageal acid exposure) in many patients,
but is associated with de novo reflux symptoms or lesions in a considerable proportion of patients. To date, Roux-en-Y gastric
bypass is the most effective bariatric procedure that consistently leads to weight reduction and improvement of GERD symptoms
in patients undergoing direct gastric bypass and among those converted from restrictive bariatric procedures to gastric bypass. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|