Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study

To prospectively evaluate the frequency of upper gastrointestinal symptoms and associated disorders in morbidly obese patients with endoscopy and histology prior to their gastric bypass surgery in comparison with age- and sex-matched nonobese control subjects.

All patients who were scheduled to undergo laparoscopic gastric bypass for treatment of morbid obesity (body mass index, BMI > 40 kg/m(2)) during a 1-year period (n = 101) were included in the study. Age- and sex-matched nonobese patients who were seen in the medical clinics during the study period were enrolled as control subjects. The demographic data, total body weight, body mass index, and gastrointestinal symptoms were recorded, and the results of upper endoscopy and histology were tabulated. Endoscopic documentation of hiatal hernia, esophagitis, gastritis, gastric polyps, and peptic ulcer disease was also noted along with the histologic findings of the mucosal biopsies from the upper gastrointestinal tract.

The prevalence of heartburn as a symptom was significantly higher (P < 0.05) in the morbidly obese patients (32.6%) compared with in the control group (18.8%). Endoscopically, the prevalence of hiatal hernia was also significantly higher (P < 0.05) in the morbidly obese group (38.6%) compared with in the control group (13.8%). Similarly the frequency of endoscopically and histologically identified gastritis was significantly higher (P < 0.01) in the morbidly obese patient group. However, the frequency of histologically identified Helicobacter pylori was not statistically different in the two groups.

These observations suggest a significant increase in the frequency of heartburn, hiatal hernia, and histologically identified gastritis in morbidly obese patients.