Gastroesophageal reflux disease and morbid obesity: evaluation and treatment

Gastroesophageal reflux disease (GERD) is markedly increased among the obese population being recognized as one of the many obesity-related comorbidities. This concept should raise awareness, making physicians investigate more profoundly about this disease in this kind of patients. Currently, bariatric surgery is considered the gold standard treatment for morbid obesity. However, not all the operations are appropriate for the treatment of GERD and not all the patients are willing to receive bariatric surgery for the treatment of GERD. Even though sleeve gastrectomy has emerged as a suitable treatment option for morbid obesity, it has been related to development of de novo GERD or worsening the pre-existing one. Conversely, results after Roux-en-Y gastric bypass have been encouraging in this aspect, and it seems to be the best option for patients who suffer both diseases. Therefore, the presence of GERD should not be ignored at the time of deciding which type of surgery will be offered to the patient.