Key result
Roux-en-Y gastric bypass is the preferred bariatric surgery for patients with GERD, whereas GERD remains a major issue following laparoscopic sleeve gastrectomy.
Why the study?
Studies investigating the relationship between bariatric surgery and GERD are discordant, prompting a review of how different bariatric surgical procedures affect GERD.
How do different bariatric surgical procedures affect gastroesophageal reflux disease in morbidly obese patients?
How do different bariatric surgical procedures affect gastroesophageal reflux disease in morbidly obese patients?
Roux-en-Y gastric bypass is the preferred bariatric procedure for patients with pre-existing GERD, while laparoscopic sleeve gastrectomy may exacerbate or induce GERD.
May support preferring RYGB over LSG in bariatric patients with GERD; leaves open need for randomized confirmation.
Bariatric surgery is the most effective treatment for morbidly obese patients. Studies investigating the relationship between bariatric surgery and gastroesophageal reflux disease (GERD) are discordant. Depending on the type of intervention, pre-existing GERD can improve, worsen, or develop “de novo” in previously unaffected patients. Therefore, a review of the literature is performed to evaluate the effects of different bariatric surgical procedures on GERD. Currently, the bariatric surgical procedures more frequently performed are laparoscopic sleeve gastrectomy (LSG) and gastric bypass. The majority of studies examining the relationship between GERD and bariatric surgery are low quality, small, and non-randomized. Furthermore, GERD has been investigated through clinical symptoms scales or questionnaires, which often do not correlate with objective endoscopic or functional findings. Therefore, the interpretation of the results of these studies is challenging. Roux-en-Y gastric bypass is considered the preferred surgical operation for bariatric patients with GERD. Despite contradictory results reported among the studies, GERD seems to be a major issue after LSG. Preliminary results on mini-gastric bypass/one anastomosis gastric bypass seem to indicate that biliary reflux might be overrated, but more long-term results are mandatory before drawing conclusions. Further studies are needed to clarify the role of extensive preoperative examinations prior to bariatric surgery, even in asymptomatic patients, and provide clear guidance regarding the indications for the bariatric surgery technique of choice according to the patient’s characteristics.
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Rebecch et al. (2022) conducted a review in Morbid obesity and gastroesophageal reflux disease (GERD). Bariatric surgery was evaluated on Gastroesophageal reflux disease (GERD) outcomes. Roux-en-Y gastric bypass is the preferred bariatric surgery for patients with GERD, whereas GERD remains a major issue following laparoscopic sleeve gastrectomy.
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