[Obesity and gastroesophageal reflux disease]

Obesity, defined as body mass index >30, and gastroesophageal reflux disease show a prevalence of 30%, and 15-20% respectively, in adults in western countries. Obesity increase prevalence of gastroesophageal reflux disease, through difference physiopathological mechanism, that involve esophageal and gastric motility, sexual hormones, dietary habits and drugs intake, presence of hiatal hernia, elevated intra-abdominal pressure. Several surgical treatment options are avalaible in obese patients, which can be divided into restrictive (acting through reduction of gastric volume), or malabsorptive techniques (acting through functional shortening of digestive tract), or a combination of both. Type of surgical approach influences gastroesophageal reflux disease outcome in obese patients with pre-existing symptoms; Roux-en-Y gastric bypass probably represents the best option for these, eligible for bariatric surgery.