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The Effect of Roux-en-Y Gastric Bypass on Gastroesophageal Reflux Disease in Morbidly Obese Chinese Patients

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Abstract

Background

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Eastern and Western countries. Obesity is recognized as a risk factor of gastroesophageal reflux disease. However, little information is available on the prevalence of gastroesophageal reflux disease in morbidly obese Chinese patients. The aim of this study was to compare the prevalence of GERD in Chinese patients with morbid obesity and age- and sex-matched controls, and we also assessed the effect of Roux-en-Y gastric bypass on reflux symptoms and erosive esophagitis.

Methods

Between November 2006 and February 2008, 150 morbidly obese Chinese patients underwent laparoscopic Roux-en-Y gastric bypass. Gastroesophageal reflux disease questionnaires and esophagogastroduodenoscopy results were assessed in all cases before surgery. The prevalence of reflux symptoms and erosive esophagitis was compared with the prevalence in a database of 300 age- and sex-matched controls. We also compared baseline and postoperative characteristics at 12 months after operation.

Results

Patients with morbid obesity had higher frequencies of reflux symptoms (16% vs. 8%, P = 0.01) and erosive esophagitis (34% vs. 17%, P < 0.01) than those of controls. Twelve months after laparoscopic Roux-en-Y gastric bypass, 26 patients received follow-up evaluations. In addition to substantial weight loss, the prevalence of reflux symptoms and erosive esophagitis decreased significantly after operation (19.2% vs. 0%, P = 0.05, and 42.3% vs. 3.8%, P < 0.01, respectively).

Conclusions

Gastroesophageal reflux disease is pervasive in Chinese patients with morbid obesity and Roux-en-Y gastric bypass substantially improves not only the reflux symptoms but also the erosive esophagitis.

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Abbreviations

GERD:

gastroesophageal reflux disease

BMI:

body mass index

LRYGB:

laparoscopic Roux-en-Y gastric bypass

NCEP-ATP III:

National Cholesterol Education Program’s Adult Treatment Panel III

EGD:

esophagogastroduodenoscopy

LA classification:

Los Angeles classification

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Authors and Affiliations

  1. Department of Internal Medicine, E-DA Hospital and I-Shou University, 1, E-Da Rd., Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan

    Chi-Ming Tai, Chi-Yang Chang, Ching-Tai Lee & Jaw-Town Lin

  2. Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chi-Ming Tai

  3. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Yi-Chia Lee, Ming-Shiang Wu & Jaw-Town Lin

  4. Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan

    Yi-Chia Lee

  5. Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung County, Taiwan

    Chih-Kun Huang

  6. Department of Health Management, I-Shou University, Kaohsiung County, Taiwan

    Hsin-Chih Kuo

  7. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Yi-Chia Lee

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  1. Chi-Ming Tai
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Correspondence to Yi-Chia Lee or Jaw-Town Lin.

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Tai, CM., Lee, YC., Wu, MS. et al. The Effect of Roux-en-Y Gastric Bypass on Gastroesophageal Reflux Disease in Morbidly Obese Chinese Patients. OBES SURG 19, 565–570 (2009). https://doi.org/10.1007/s11695-008-9731-4

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  • DOI: https://doi.org/10.1007/s11695-008-9731-4

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