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Published on: June 11, 2012
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Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass
Fabio Butti1,2, Olivier Tobler1, Pierre Allemann3,4
1Service de Chirurgie Générale, Groupement Hospitalier de l'Ouest Lémanique, Hôpital de Nyon, Chemin de Monastier, Nyon, Switzerland.
Summary
Gastroesophageal reflux disease (GERD) in obese patients may persist after Roux-en-Y gastric bypass (RYGB). This review explores surgical and endoscopic options for managing refractory GERD post-RYGB when initial treatments fail.
Area of Science:
- Bariatric Surgery
- Gastroenterology
- Obesity Medicine
Background:
- Gastroesophageal reflux disease (GERD) is a common comorbidity in obese individuals, affecting over 50% of this population.
- Roux-en-Y gastric bypass (RYGB) is a primary surgical treatment for obesity and GERD, yet some patients experience persistent or refractory GERD post-operatively.
Purpose of the Study:
- To review and discuss current surgical and endoscopic treatment options for managing GERD that is refractory to treatment after RYGB.
- To highlight the need for further research comparing different management strategies.
Main Methods:
- A literature review was conducted using the PubMed database.
- Articles published before December 2019 focusing on GERD management after RYGB were included.
- Six studies (four case reports, two retrospective studies) were identified.
Main Results:
- Pharmacological therapy and lifestyle modifications are initial treatments for GERD post-RYGB.
- New surgical and endoscopic strategies have emerged to address refractory GERD, considering the anatomical changes from RYGB.
- Limited comparative data exists for these advanced interventions.
Conclusions:
- Refractory GERD after RYGB requires specialized management, including surgical and endoscopic approaches.
- Treatment selection depends on patient-specific factors, local expertise, and resource availability.
- Further comparative studies are essential to guide optimal treatment decisions for this patient subgroup.
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