Use of Preoperative Endoscopic Capsule-Based pH Testing Before Bariatric Surgery.

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Vertical sleeve gastrectomy is the most common bariatric procedure in the US.
• A significant portion of patients experience persistent or new-onset gastroesophageal reflux disease (GERD) after surgery.
• There is no established consensus for objective preoperative GERD evaluation.

Purpose of the Study:

• To compare capsule-based pH testing with GERD symptom scoring for preoperative GERD assessment.
• To determine the utility of objective testing in guiding bariatric surgery procedure selection.
• To inform the preoperative consent process for patients undergoing bariatric surgery.

Main Methods:

• Retrospective review of 62 patients undergoing bariatric surgery consultation.
• Administration of a validated GERD symptom subjective survey.
• Upper endoscopy with capsule-based pH testing for patients interested in sleeve gastrectomy or with a history of reflux.

Main Results:

• No significant linear association was found between objective DeMeester scores and subjective GERD symptom scores.
• Median GERD symptom scores did not differ between patients with and without GERD diagnosed by pH testing (p > 0.11).
• 66.1% of patients were not on proton-pump inhibitors prior to pH testing.

Conclusions:

• Objective methods like capsule-based pH testing may be superior to subjective symptom scoring for preoperative GERD identification.
• Accurate preoperative GERD assessment can aid in bariatric procedure selection and informed consent.
• Patients with significant preoperative GERD may face higher risks of post-sleeve gastrectomy complications.