Tu1809 Preoperative Esophagogastric Junction (EGJ) Distensibility Predicts Treatment Outcome After Endoscopic Fundoplication in GERD Patients

Abstract

G A A b st ra ct s reduction of proton pump inhibitors (PPI) therapy after the weight loss. MATERIAL AND METHODS: we enrolled a group of 50 overweight and obese patients with typical and atypical GERD symptoms with previous erosive esophagitis endoscopically proven. These patients were evaluated with two validated questionnaires (QOLRAD and VAS) to detect the prevalence of GERD related symptoms and the ongoing PPI therapy. All patients underwent an anthropometric evaluation (BMI, height, weight, abdominal circumference) and received a personalized hypo-caloric diet with 1200-1500Kcal for women and 1500-1800Kcal for men. The hypocaloric diet was considered effective if at least of 10% weight loss was obtained in each patient. The hypocaloric diet was completed within 6 months. The same anthropometric evaluation and questionnaires were performed at the end of treatment. The results were evaluated with a Student paired t-test and considered statistically significant when p value was , 0.05. RESULTS: Male/female ratio was 0.78 (22/28). Mean age was 49.3(±11,8). Mean BMI decreased from 30.3 (sd ±4,1) to 25.7(±3.1) (p,0.05) and the mean weight loss from 82.1(±16.9) to 69.9 (±14,4) after hypocaloric diet (p,0.05). Symptoms perception decreased both with QUOLRAD and VAS scale (p,0.05). In particular, heartburn decreased from 3.68(±1.9) to 0.28(±0.4) in QUOLRAD scale and from 5.7(±1.8) to 0.6(±0.6) in VAS scale (p,0.05). PPI therapy was completely discontinued in 27/50 (54%) patients, was halved in 16/50 (32%) patients. Only 7/50 (14%) continued the same PPI dosage. CONCLUSION:we can conclude that a 10% of weight loss is recommended in all patients with GERD-related symptoms. This weight reduction could be able to reduce not only symptoms perception but also the dose of PPI therapy.