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[Pathological gastroesophageal reflux in patients with severe, morbid and hyper obesity]
A Csendes1, P Burdiles, J Rojas
1Departamento de Cirugía, Centro de Gastroenterología Hospital Clínico, Universidad de Chile, Santiago, Chile.
Background:
Overweight can be a risk factor for pathological gastroesophageal reflux or hiatal hernia.
Aim:
To study the prevalence of gastroesophageal reflux in patients with severe obesity.
Patients And Methods:
Sixty seven patients, 51 female, aged 17 to 56 years old with a body mass index over 35 kg/m2, were studied. An upper gastrointestinal endoscopy was performed in all, esophageal manometry was done in 32 and 24 h pH monitoring was done in 32 patients.
Results:
Seventy nine percent of patients complained of heartburn and 66% of regurgitation. In 16 patients, endoscopy was normal. An erosive esophagitis was found in 33 patients, a short columnar epithelium in 12 and a Barret esophagus with intestinal metaplasia in six. Normal endoscopic findings and erosive esophagitis were present with a higher frequency in women. No association between the degree of obesity and esophageal lesions was observed. Lower esophageal sphincter pressure and abdominal length were significantly higher in subjects with a body mass index over 50 compared to those with a body mass index between 35 and 39.9 kg/m2. No differences were observed in 24 h pH monitoring.
Conclusions:
A high proportion of severely obese patients had symptoms and endoscopical findings of pathological gastroesophageal reflux.