Gastroesophageal reflux disease in patients with morbid obesity

Abstract

Aim. To study the prevalence and manifestations of gastroesophageal reflux disease (GERD) in patients with morbid obesity based on endoscopic, X-ray findings and the function of the lower esophageal sphincter. Materials and methods. The study involved 98 obese patients with a mean body mass index (BMI) of 55.6 ± 10.3 kg/m2. Of these, 30 were men (34.48 %) and 68 were women (65.52 %) aged 18–64 years, mean age – 42.3 ± 8.5. All the patients subsequently underwent fibroesophagogastroduodenoscopy, esophagomanometry, 24-hour esophageal pH monitoring, X-ray examination and bariatric surgery. The presence and severity of pathological gastroesophageal reflux were assessed using esophageal pH monitoring data based on the DeMeester score. In addition, the lower esophageal sphincter function was assessed, the number of refluxes and the duration of the longest reflux episode were calculated according to the data of esophagomanometry and 24-hour esophageal pH monitoring. Statistical data processing was carried out using the StatPlus 2007 software package. Results. In this paper, we studied the prevalence and manifestations of gastroesophageal reflux in 98 obese patients. The mean BMI was 55.6 ± 10.3 kg/m2, the maximum was 72 kg/m2. GERD was diagnosed in 37 (37.76 %) patients, including 8 (8.16 %) patients with a hiatal hernia. The erosive form prevailed in the GERD pattern – in 24 (24.48 %) patients. In 32 (32.65 %) examined patients, pathological reflux was diagnosed during the daytime, especially after eating. Conclusions. The study results indicate that 37.76 % of obese patients are diagnosed with GERD arising from anatomical features and function of the gastroesophageal junction with the predominance of erosive forms of GERD. The state of the gastroesophageal junction in obese patients should be considered when choosing the optimal bariatric or metabolic surgery.