Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients.

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Tytuł:: Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients.
Autorzy:: Kristo I; Department of Surgery, Upper GI Research and Service, Comprehensive Cancer Center, Gastroesophageal Tumor Unit, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Paireder M; Department of Surgery, Upper GI Research and Service, Comprehensive Cancer Center, Gastroesophageal Tumor Unit, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Jomrich G; Department of Surgery, Upper GI Research and Service, Comprehensive Cancer Center, Gastroesophageal Tumor Unit, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Felsenreich DM; Department of Surgery, Metabolic & Bariatric Surgery, Medical University of Vienna, Vienna, Austria.
Nikolic M; Department of Surgery, Upper GI Research and Service, Comprehensive Cancer Center, Gastroesophageal Tumor Unit, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Langer FB; Department of Surgery, Metabolic & Bariatric Surgery, Medical University of Vienna, Vienna, Austria.
Prager G; Department of Surgery, Metabolic & Bariatric Surgery, Medical University of Vienna, Vienna, Austria.
Schoppmann SF; Department of Surgery, Upper GI Research and Service, Comprehensive Cancer Center, Gastroesophageal Tumor Unit, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .
Źródło:: Obesity surgery [Obes Surg] 2019 Nov; Vol. 29 (11), pp. 3536-3541.
Typ publikacji:: Historical Article; Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 2006- : New York : Springer Science + Business Media
Original Publication: Oxford, OX, UK : Rapid Communications of Oxford, [1991-
MeSH Terms:: Diagnostic Techniques, Digestive System*/history
Diagnostic Techniques, Digestive System*/trends
Manometry*/history
Manometry*/methods
Esophagus/*physiology
Gastroesophageal Reflux/*complications
Gastroesophageal Reflux/*diagnosis
Obesity, Morbid/*complications
Adult ; Esophageal Motility Disorders/epidemiology ; Esophageal Motility Disorders/etiology ; Esophageal Motility Disorders/physiopathology ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux/epidemiology ; Gastroesophageal Reflux/physiopathology ; History, 21st Century ; Humans ; Male ; Middle Aged ; Obesity, Morbid/diagnosis ; Obesity, Morbid/epidemiology ; Obesity, Morbid/physiopathology ; Prevalence ; Sensitivity and Specificity
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Contributed Indexing:: Keywords: Gastroesophageal reflux disease; Morbidly obese; Motility disorders
Entry Date(s):: Date Created: 20190616 Date Completed: 20200526 Latest Revision: 20210109
Update Code:: 20240105
DOI:: 10.1007/s11695-019-04020-1
PMID:: 31201693
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Background: The implementation of high-resolution manometry (HRM) and the Lyon Consensus statement facilitate evaluation of gastroesophageal reflux disease and motility disorders in morbidly obese patients. Therefore, we aimed to investigate prevalence and phenotype of (borderline) GERD and esophageal motility disorders in this population.
Methods: Consecutive morbidly obese (BMI ≥ 35 kg/m 2 ) patients were offered evaluation by means of HRM, ambulatory 24-h pH impedance monitoring, endoscopy, and a clinical examination at our tertiary academic center. Data were collected prospectively.
Results: Out of 448 eligible individuals, 147 patients (females = 75, 51%) with a median age of 41.6 (33.4; 52.3) years and a BMI of 44 (40.9; 49.4) kg/m 2 were included during the study period. The Chicago Classification revealed motility disorders in 50 (34%) patients, dominated by outflow obstruction (18.4%, n = 27) and a novel disorder (7.5%, n = 11), nicknamed jackhammer esophagus (JE). According to the Lyon Consensus, 52 (35.4%) patients had evidence of true GERD, whereas borderline GERD was noted in another 60 (40.8%). Hypersensitive esophagus was observed in 6.8% (n = 10). Sensitivity and specificity of symptoms for GERD were 53.8% and 68.4%, respectively.
Conclusions: The current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE in obesity and to identify risk factors for adverse outcomes following bariatric surgery.

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