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Upper Gastrointestinal Symptoms and Associated Disorders in Morbidly Obese Patients: A Prospective Study

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Abstract

Objective To prospectively evaluate the frequency of upper gastrointestinal symptoms and associated disorders in morbidly obese patients with endoscopy and histology prior to their gastric bypass surgery in comparison with age- and sex-matched nonobese control subjects. Methods All patients who were scheduled to undergo laparoscopic gastric bypass for treatment of morbid obesity (body mass index, BMI > 40 kg/m2) during a 1-year period (n = 101) were included in the study. Age- and sex-matched nonobese patients who were seen in the medical clinics during the study period were enrolled as control subjects. The demographic data, total body weight, body mass index, and gastrointestinal symptoms were recorded, and the results of upper endoscopy and histology were tabulated. Endoscopic documentation of hiatal hernia, esophagitis, gastritis, gastric polyps, and peptic ulcer disease was also noted along with the histologic findings of the mucosal biopsies from the upper gastrointestinal tract. Results The prevalence of heartburn as a symptom was significantly higher (P < 0.05) in the morbidly obese patients (32.6%) compared with in the control group (18.8%). Endoscopically, the prevalence of hiatal hernia was also significantly higher (P < 0.05) in the morbidly obese group (38.6%) compared with in the control group (13.8%). Similarly the frequency of endoscopically and histologically identified gastritis was significantly higher (P < 0.01) in the morbidly obese patient group. However, the frequency of histologically identified Helicobacter pylori was not statistically different in the two groups. Conclusion These observations suggest a significant increase in the frequency of heartburn, hiatal hernia, and histologically identified gastritis in morbidly obese patients.

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References

  1. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among U.S. adults, 1999–2000. JAMA. 2002;288:1723–1727.

    Article  PubMed  Google Scholar 

  2. Burton BT, Foster WR, Hirsch J, et al. Health implications of obesity. National Institute of Health Consensus Development conference statement. Ann Intern Med. 1985;103:1073–1077.

    Google Scholar 

  3. Delgado-Aros S, Locke Gr, Camilleri M, et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population based study. Am J Gastroenterol. 2004;99:1801–1806. doi:10.1111/j.1572-0241.2004.30887.x.

    Article  PubMed  Google Scholar 

  4. Sutter M, Dorta G, Giusti V, et al. Gastroesophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14:959–966. doi:10.1381/0960892041719581.

    Article  Google Scholar 

  5. Stene-Larson G, Weberg R, Froshov Larson I, et al. Relationship of overweight to hiatus hernia and reflux esophagitis. Scand J Gastroenterol. 1988;23:427–432. doi:10.3109/00365528809093890.

    Article  Google Scholar 

  6. Lundell L, Ruth M, Sandberg N, et al. Does massive obesity promote abnormal gastroesophageal reflux. Dig Dis Sci. 1995;40:1632–1635. doi:10.1007/BF02212682.

    Article  PubMed  CAS  Google Scholar 

  7. Buchwald H. Consensus conference statement: bariatric surgery for morbid obesity; health implications for patients, health professionals and third party players. J Am Coll Surg. 2005;200:593–604. doi:10.1016/j.jamcollsurg.2004.10.039.

    Article  PubMed  Google Scholar 

  8. Freedman DS, Khan LK, Serdula MK, et al. Trends and correlates of class 3 obesity in the United States from 1990 through 2000. JAMA. 2002;288(14):1758–1761. doi:10.1001/jama.288.14.1758.

    Article  PubMed  Google Scholar 

  9. NIH consensus statement. Gastrointestinal surgery for severe obesity. NIH Consensus Development Conference. 1991;9

  10. Singh R, Fisher BL. Sensitivity and specificity of post operative upper GI series following gastric bypass. Obes Surg. 2003;13:73–75. doi:10.1381/096089203321136629.

    Article  PubMed  Google Scholar 

  11. Crowell MD, Cheskin LJ, Musial F. Prevalence of gastrointestinal symptoms in obese and normal weight binge eaters. Am J Gastroenterol. 1994;89:387–391.

    PubMed  CAS  Google Scholar 

  12. Locke GRIII, Talley NJ, Fett SL, et al. Risk factors associated with symptoms of gastroesophageal reflux. Am J Med. 1999;106:642–649. doi:10.1016/S0002-9343(99)00121-7.

    Article  PubMed  Google Scholar 

  13. Tally NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol. 2004;99:1807–1814. doi:10.1111/j.1572-0241.2004.30388.x.

    Article  Google Scholar 

  14. Frezza EE, Shebani KO, Robertson J, et al. Morbid obesity causes, chronic increase of intraabdominal pressure. Dig Dis Sci. 2007;52:1038–1041.

    Article  PubMed  Google Scholar 

  15. Mahmood Z, Mc Namara D. Gastroesophageal reflux disease and ulcer disease. Aliment Pharmacol Ther. 2003;18(suppl 3):31–37.

    Article  PubMed  Google Scholar 

  16. Renshaw AA, Rabaza JR, Gonzalez AM, et al. Helicobacter pylori infection in patients undergoing gastric bypass surgery for morbid obesity. Obes Surg. 2001;11(3):281–283.

    Article  PubMed  CAS  Google Scholar 

  17. Everhart JE, Kruszon- Moran D, et al. Seroprevalence and ethnic differences in Helicobacter pylori infection among adults in the United States. J Infect Dis. 2000;181:1359–1363.

    Article  PubMed  CAS  Google Scholar 

  18. Zigman JM, Elmquist JK. Minireview: from anorexia to obesity—the Yin and Yang of body weight control. Endcrinology. 2003;144(9):3749–3756.

    Article  CAS  Google Scholar 

  19. Lee H-M, Wang G, Englander EW, et al. Ghrelin, a new gastrointestinal endocrine peptide that stimulates insulin secretion: enteric distribution, ontogeny, influence of endocrine, and dietary manipulations. Endocrinology. 2002;143(1):185–190.

    Article  PubMed  CAS  Google Scholar 

  20. Mora M, Scarfone A, Valenza V, et al. Ghrelin does not influence gastric emptying in obese subjects. Obes Res. 2005;13:739–744.

    Article  CAS  Google Scholar 

  21. Tschop M, Weyer C, Tataranni PA, et al. Circulating ghrelin levels are decreased in human obesity. Diabetes. 2001;50:707–709.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Sudhir K. Dutta.

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Dutta, S.K., Arora, M., Kireet, A. et al. Upper Gastrointestinal Symptoms and Associated Disorders in Morbidly Obese Patients: A Prospective Study. Dig Dis Sci 54, 1243–1246 (2009). https://doi.org/10.1007/s10620-008-0485-6

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  • DOI: https://doi.org/10.1007/s10620-008-0485-6

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