Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass
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Background: The purpose of this study was to determine the effect of laparoscopic Roux-en-Y gastric bypass (LRYGBP) on symptomatic control of gas-troesophageal reflux disease (GERD). Methods: Morbidly obese patients (n = 435) who un-derwent LRYGBP for morbid obesity were assessed for changes in GERD symptoms, quality of life, and patient satisfaction after surgery. Results: A total of 238 patients (55%) had evidence of chronic GERD, and 152 patients (64%) voluntarily participated in the study. The mean body mass index (BMI) was 48 kg/m2. The mean excess weight loss was 68.8% at 12 months. There was a significant decrease in GERD-related symptoms, including heartburn (from 87% to 22%, p < 0.001); water brash (from 18% to 7%, p<0.05); wheezing (from 40% to 5%, p<0.001) laryngitis (from 17% to 7%, p < 0.05); and aspiration (from 14% to 2%, p<0.01) following LRYGBP. Post-operatively, the use of medication decreased significantly both for proton pump inhibitors (from 44% to 9%, p < 0.001) and for the H2 blockers (from 60% to 10%, p < 0.01). SF-36 physical function scores and the mental component summary scores improved after the operation (87 vs 71; p < 0.05 and 83 vs 66; p < 0.05, respectively). Overall patient satisfaction was 97%. Conclusion: LRYGBP results in very good control of GERD in morbidly obese patients with follow-up as late as 3 years. Morbidly obese patients who require surgery for GERD may be better served by LRYGBP than fundoplication because of the additional benefit of significant weight loss.
Key wordsGastroesophageal reflux Obesity GERD Bariatric surgery Roux-en-Y gastric bypass Quality of life
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