Upper Gastrointestinal Symptoms in Obese Patients and Their Outcomes After Bariatric Surgery

Table 3.  Effects of bariatric surgery on dysphagia.

Procedure	Patients (n)	Patients presurgery (%)	Patients postsurgery (%)	Follow-up (months)	Ref.
RNYGB	43	10.9	17.7	6	[52]
	86	13	30	6	[54]
	40	20	45	3	[57]
			30	12
LAGB	43	0	0	6	[66]
LSG	23	0	4.3	12	[91]

LAGB: Laparoscopic adjustable gastric banding; LSG: Laparoscopic sleeve gastrectomy; RNYGB: ROUX-en-Y gastric bypass.

Table 4.  Effects of laparoscopic adjustable gastric banding on gastroesophageal reflux disease.

Patients (n)	GERD symptoms		Heartburn		Regurgitation		Follow-up (months)	Ref.
	Patients presurgery (%)	Patients postsurgery (%)	Patients presurgery (%)	Patients postsurgery (%)	Patients presurgery (%)	Patients postsurgery (%)
12	58.3	16.7					24–40	[55]
395	43	12.3					24	[64]
31	48.4	16.1					7–32	[65]
43	27.9	2.3					6	[66]
587	27.9	8.9					12–49	[67]
274	16	4.4					24	[68]
43	28.8	17.7					10	[69]
49	0	26.5					12	[70]
26	0	11.5					96
31		19.4	33.3				59	[71]
					0	33.3
26		42.3	23.1				6	[72]
					7.7	53.8

GERD: Gastroesophageal reflux disease.

Authors and Disclosures

>Marilia Carabotti*¹, Carola Severi¹, Frida Leonetti², Francesco De Angelis³, Olga Iorio³, Enrico Corazziari¹ and Gianfranco Silecchia<sup>3

1</sup>Department of Internal Medicine & Medical Specialties, University Sapienza of Rome, Rome, Italy
²Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
³Department of Medical Surgical Sciences and Biotechnology, University Sapienza of Rome, Rome, Italy

Financial & competing interest disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

*Author for correspondence
Tel.: +39 064 997 8369 Fax: +39 064 463 737 mcarabotti@yahoo.it

Sidebar

Key Issues

• Prevalence of gastroesophageal reflux disease is higher in obese patients than normal weight controls, with an increased risk to develop symptoms and erosive esophagitis.

• In obese patients, esophageal motility disorders are not uncommon and are frequently asymptomatic. There is often a discrepancy between altered manometric findings and the presence of gastrointestinal symptoms, which are likely to be ascribed to a dysfunction in the autonomic nervous system. It could be worthwhile to undertake esophageal manometry before restrictive bariatric procedures.

• Different surgical approaches are associated with different gastrointestinal clinical outcomes. Roux-en-Y gastric bypass is the most efficacious antireflux strategy.

• Laparoscopic sleeve gastrectomy, only recently used as definitive treatment, requires more studies to define gastrointestinal outcomes.