Impact of meal frequency on gastroesophageal reflux disease following laparoscopic sleeve gastrectomy

Background Saudi Arabia has a high obesity rate (> 35%), increasing the risk of gastroesophageal reflux disease (GERD) and presents major health risks. Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric surgery that reduces mortality. Controversies exist regarding the recommended meal frequency following bariatric surgery, as some patients experience increased GERD symptoms postoperatively. In this study, we describe the association between meal frequency and GERD at least one year after LSG. Methods We conducted a retrospective cohort study based on data collected from electronic medical records over a six-year period (2016–2022) at a private gastroenterology clinic in the Kingdom of Saudi Arabia. Clinical, endoscopic, and radiological examinations of the upper gastrointestinal tract were reviewed as indicated. Paired-sample t-tests and two-way analyses of variance (ANOVA) were performed. Results The study included 109 participants (62 women, 47 men) aged 17–66 years, mostly Saudi Arabian. All patients lost weight, with Body mass index (BMI) decreasing from 46.37 to 31.24 kg/m 2 . Primary complaints were heartburn (77.1%), epigastric pain (70.6%), retrosternal burning (50.5%), nausea (35.8%), and vomiting (30.3%). Only 15.6% had a history of preoperative endoscopy. Typical long-term daily postoperative meal patterns were 1–2 meals (43%), 3–4 meals (28.4%), 5–6 meals (8.2%), and more than six meals (4.6%). Most patients with RO consumed 1–2 meals (19.2%) or 3–4 meals (15.6%), compared to 5–6 meals (4.6%) and over six meals (0.9%). No significant association was observed between meal frequency and RO ( p = 0.09, 0.24, 1.00). Conclusions Large daily meals, with few frequent meals that meet daily caloric requirements, did not show statistically significant association with reflux oesophagitis (RO).