Prevalence of gastroesophageal reflux disease in obese patients eligible for bariatric surgery

Abstract

Objective:To determine the prevalence and characteristics of gastroesophageal reflux disease (GERD) in obese patients at the Mário Covas State Hospital (Hospital Estadual Mário Covas) who are candidates to bariatric surgery through complementary examinations. Methods:One hundred and fifty obese patients eligible for bariatric surgery were evaluated using three diagnostic methods for GERD (questionnaire, upper gastrointestinal endoscopy [UGE], and 24-hour esophageal pH monitoring [EPM]). Ambulatory esophageal manometry (AEM) complemented the anatomical-physiological study of GERD. Results:The results of 24-hour EPM indicated that the prevalence of GERD in the study population was 42.7%. Similar prevalence rates (65% and 54.2%) were found in other studies. The questionnaire results were not significantly correlated with the results of complementary examinations and body mass index. UGE results showed that the prevalence of hiatal hernia was low (13%). The prevalence of erosive reflux esophagitis (ERE) was significantly higher in the study population (38.0%) than in the general population (11.8–15.5%). No acid reflux-related complications were observed. The results of AEM showed that 60% of patients had esophageal motility changes. Transient lower esophageal sphincter (LES) relaxation was the most common motility disorder and was significantly associated with ERE (p=0.010) and distal gastroesophageal reflux (GER) (p=0.038). Body mass index was significantly correlated with distal GER (p=0.017) on EPM. Conclusion:The prevalence of GERD was high in obese patients eligible for bariatric surgery. Erosive reflux esophagitis and Hypotonic LES were significantly associated with acid reflux. Typical reflux symptoms were not useful diagnostic indicators of GERD in this population.