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Surgical management of gastroesophageal reflux disease in the obese patient

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Abstract

Background

Gastroesophageal reflux disease (GERD) affects two thirds of the American population. Obesity is also a disease that affects two thirds of the population. The pathophysiology of reflux disease is reasonably understood, however, the degree to which obesity affects this disease remains poorly defined. Therefore the approach to GERD in the obese patient requires special attention and its own algorithm.

Methods

A literature search was conducted to consolidate the current available literature on GERD and its management in the obese. In addition, the authors reviewed the literature and present expert opinion on controversial topics.

Results

It is well established that GERD is increased in obesity and the pathophysiology is reviewed. Management options for GERD are discussed, with a focus on the obese population. Management strategies including fundoplication and gastric bypass are discussed. In addition, bariatric surgery in the setting of GERD is also reviewed.

Conclusions

Currently this is an extremely controversial topic and this white paper presents a strong review of the literature to help guide the management of this challenging disease in this population. Expert recommendations are given throughout the paper based upon the current available data.

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Author information

Authors and Affiliations

  1. Department of Surgery, Carver College of Medicine, Iowa City, IA, USA

    P. Nau

  2. George Washington School of Medicine and Life Sciences, Washington, DC, USA

    H. T. Jackson

  3. Department of Surgery, Texas Tech, Lubbock, TX, USA

    A. Aryaie

  4. University of Utah College of Medicine, Salt Lake City, UT, USA

    A. Ibele

  5. Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA

    D. Shouhed

  6. Department of Surgery, Cleveland Clinic Florida, Weston, FL, USA

    E. Lo Menzo

  7. New York University School of Medicine, New York, NY, USA

    M. Kurian

  8. Cleveland Medical Center, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    L. Khaitan

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  1. P. Nau
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SAGES Foregut Task Force White Paper

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Correspondence to L. Khaitan.

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Disclosures

P Nau, H. Jackson, A. Aryaie, A. Ibele, D. Shouhed, E. Lo Menzo, M. Kurian, L. Khaitan have no conflicts of interest or financial ties to disclose.

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Nau, P., Jackson, H.T., Aryaie, A. et al. Surgical management of gastroesophageal reflux disease in the obese patient. Surg Endosc 34, 450–457 (2020). https://doi.org/10.1007/s00464-019-07231-w

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