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Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
284
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Post Sleeve Reflux: indicators and impact on outcomes.

Jonathan Z Li1, Ryan C Broderick2, Estella Y Huang2

  • 1Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, MET Building, Lower Level, 9500 Gilman Drive, MC 0740, La Jolla, CA, 92093-0740, USA. jzl023@health.ucsd.edu.

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Summary

Post-operative gastroesophageal reflux disease (GERD) significantly impacts patients after sleeve gastrectomy (SG). Elevated preoperative DeMeester scores predict GERD risk, and these patients experience higher reintervention rates.

Keywords:
EGDGERDManometryRefluxSleeve gastrectomypH monitoring

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Area of Science:

  • Bariatric Surgery
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Post-operative gastroesophageal reflux disease (GERD) is a common complication following sleeve gastrectomy (SG).
  • Understanding the incidence and impact of GERD is crucial for improving patient outcomes after SG.

Purpose of the Study:

  • To evaluate the incidence and impact of post-operative GERD after sleeve gastrectomy.
  • To identify predictors of GERD development and assess outcomes in patients with and without post-operative GERD.

Main Methods:

  • Retrospective review of a prospectively maintained database of laparoscopic or robotic SG patients.
  • Analysis of weight loss, GERD rates (de-novo or aggravated), and re-intervention rates.
  • Subgroup analysis comparing patients with and without post-operative GERD, including preoperative pH testing.

Main Results:

  • 17% of 392 SG patients developed de-novo or aggravated GERD.
  • Patients with post-operative GERD had higher excess weight loss at 9 months and significantly higher rates of re-intervention (14% vs 1%).
  • Elevated preoperative DeMeester scores on pH testing were associated with post-operative GERD (34.8 vs 18.9).

Conclusions:

  • Preoperative DeMeester scores may indicate risk for post-operative GERD after SG.
  • Post-operative GERD in SG patients is associated with increased need for re-intervention.