Document Detail

Obesity and gastro-esophageal acid reflux: physiopathological mechanisms and role of gastric bariatric surgery.
MedLine Citation:
PMID:  15479599     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Controversial findings about the relationships between obesity and gastro-esophageal reflux have been reported, as well as about the effects of weight loss and bariatric surgery on reflux. The aims of this study were to evaluate esophageal motility and gastro-esophageal acid circadian patterns in obese patients and to test the effects of vertical banded gastroplasty (VBG) on these parameters. METHODS: 14 obese subjects (BMI 36-53 kg/m2), 4 men, 10 women, 27-61 years old, admitted for elective bariatric surgery, underwent clinical evaluation, upper endoscopy, esophageal manometry and gastroesophageal pH monitoring. Evaluations were repeated 6 to 12 months after gastric surgery that consisted of a VBG (7 patients), accompanied in the other 7 patients with an anti-reflux procedure (fundoplication). Manometric and pH-metric findings in the obese patients were compared with a normal-weight control group before and after the two different surgical treatments. RESULTS: Gastro-esophageal reflux was significantly more frequent in obese (57.1%) than in control group (7.1%). Esophageal motility in obese subjects was not different from controls. After VBG alone, we found a reduction in basal lower esophageal sphincter (LES) pressure and an increase of acid reflux. When VBG was accompanied by fundoplication, basal LES pressure increased and acid reflux frequency decreased. CONCLUSIONS: Obesity is associated with gastroesophageal reflux. VBG reduced weight, but not gastro-esophageal acid reflux. Therefore, in our population, this operation cannot be considered as an antireflux procedure.
Vincenzo Di Francesco; Elda Baggio; Marina Mastromauro; Elena Zoico; Norma Stefenelli; Mauro Zamboni; Maria Panagiota Panourgia; Luca Frulloni; Paolo Bovo; Ottavio Bosello; Giorgio Cavallini
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Obesity surgery     Volume:  14     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-13     Completed Date:  2005-01-11     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1095-102     Citation Subset:  IM    
Department of Biomedical and Surgical Sciences, University of Verona, Verona, Italy.
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MeSH Terms
Circadian Rhythm
Diagnostic Techniques, Digestive System
Gastroesophageal Reflux / diagnosis,  etiology,  physiopathology*
Gastrointestinal Motility / physiology
Gastroplasty / adverse effects*
Middle Aged
Obesity, Morbid / complications,  physiopathology,  surgery*
Prospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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