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The Effects of Bariatric Surgery and Endoscopic Bariatric Therapies on GERD: An Update

  • Esophagus (P Iyer, Section Editor)
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Abstract

Purpose of review

Bariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.

Findings

Recent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett’s esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The intragastric balloon (IGB) has been associated with increased likelihood of GERD, whereas insufficient evidence exists linking endoscopic sleeve gastroplasty (ESG) to GERD.

Summary

Gastroesophageal reflux disease may be treated with some bariatric procedures but is often developed de novo as a result of the change in anatomy. Patients set to undergo bariatric surgery may benefit from pre-procedural endoscopy to choose the more suitable therapy. Further studies with objective measurements of GERD post procedure may provide more insight into the effects of bariatric therapies on reflux, especially more novel ones such as ESG.

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Acknowledgments

Vivek Kumbhari is a consultant for Apollo Endosurgery, Boston Scientific, Medtronic, Pentax Medical, and ReShape Lifesciences. He has also received research support from Erbe and Apollo Endosurgery.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA

    Mohamad I. Itani, Jad Farha, Mohamad Kareem Marrache, Lea Fayad, Dilhana Badurdeen & Vivek Kumbhari

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  1. Mohamad I. Itani
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  2. Jad Farha
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  3. Mohamad Kareem Marrache
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Literature search (MI); authored first draft (MI, JF, MKM); critical revisions (LF, DB, VK); approved final draft (all).

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Correspondence to Vivek Kumbhari.

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Mohamad I. Itani declares that he/she has no conflict of interest. Jad Farha declares that he/she has no conflict of interest. Mohamad Kareem Marrache declares that he/she has no conflict of interest. Lea Fayad declares that he/she has no conflict of interest. Dilhana Badurdeen declares that he/she has no conflict of interest. Vivek Kumbhari declares that he/she has no conflict of interest.

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Itani, M.I., Farha, J., Marrache, M.K. et al. The Effects of Bariatric Surgery and Endoscopic Bariatric Therapies on GERD: An Update. Curr Treat Options Gastro 18, 97–108 (2020). https://doi.org/10.1007/s11938-020-00278-y

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