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Functional Lumen Imaging Probe Panometry Findings in Obese Patient Populations.

Anh D Nguyen1,2, Anjali Bhatt3, Ambreen Merchant2

  • 1Division of Gastroenterology and Baylor Scott & White Center for Esophageal Diseases, Baylor University Medical Center, Dallas, Texas, USA.

Neurogastroenterology and Motility
|December 9, 2024
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Summary

Most obese patients, with or without bariatric surgery, show abnormal functional lumen imaging probe (FLIP) patterns, often linked to dysphagia and chest pain. These FLIP abnormalities do not correlate with high-resolution manometry (HRM) findings.

Keywords:
bariatric surgeryesophageal motilityfunctional luminal imaging probe (FLIP) panometryobesityroux‐en‐Y gastric bypasssleeve gastrectomy

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Area of Science:

  • Gastroenterology
  • Bariatric Surgery
  • Esophageal Physiology

Background:

  • Limited data exist on functional lumen imaging probe (FLIP) findings in obese individuals.
  • Obesity is associated with various gastrointestinal symptoms and complications.
  • Bariatric surgery, including sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), is a common treatment for obesity.

Purpose of the Study:

  • To evaluate FLIP metrics in obese patients before and after bariatric surgery (SG and RYGB).
  • To assess the correlation between FLIP abnormalities, esophageal symptoms, and high-resolution manometry (HRM) findings.
  • To determine the clinical utility of FLIP in obese patients with esophageal symptoms.

Main Methods:

  • A retrospective analysis of 228 obese patients who underwent FLIP.
  • Patients were categorized into surgery-naïve, post-SG, and post-RYGB groups.
  • Esophageal symptoms, HRM data, and FLIP metrics (e.g., EGJ diameter, EGJ-DI, ACR, SRCR) were recorded and analyzed.

Main Results:

  • Dysphagia and chest pain were prevalent symptoms across all groups.
  • Abnormal FLIP response patterns were observed in a majority of patients (65-74%).
  • Higher abnormal contractile response (ACR) rates were noted post-SG and RYGB, while lower spontaneous contractile response (SRCR) rates were seen compared to surgery-naïve patients. No significant associations were found between FLIP patterns and symptoms or HRM diagnoses.

Conclusions:

  • Obese patients, regardless of bariatric surgery status, frequently exhibit abnormal FLIP contractile response patterns.
  • These FLIP abnormalities do not consistently correlate with esophageal symptoms or HRM findings.
  • FLIP may offer valuable insights in obese patients with esophageal symptoms, particularly when HRM results are inconclusive.