Patricio Cal, MD, Luciano Deluca, MD, Tomas Jakob, Diego Lonardi, Ezequiel Fernandez. Hospital Churruca
Introduction: Gastroesophageal reflux disease (GERD) is a highly prevalent disease estimated to be present in 10-20% of Western adult population. Obesity has been established as a well-known risk factor. The goal of this study was to evaluate the presence of pre-surgical GERD among the bariatric population.
Methods & Procedures: Between March 2014 and June 2017 246 patients underwent 24 hour pH-metry, manometry and upper GI endoscopy as part of a routine screening for GERD. Gender, age, BMI, DeMeester score, lower esophageal sphincter (LES) resting pressure and signs of esophagitis were recorded in a prospectively kept database.
Results were reported as means ± standard deviations or 95% confidence intervals (95%CI). Correlation between variables was studied using either Pearson or Spearman correlation tests and simple linear regression. Groups were compared with t-test, and a significance level of 0.05 was set.
Results: Mean age was 43.4±11.7 years and BMI 44.3±6.3 kg/m2, 72.8% were female. Mean DeMeester score was 48.8(95%CI 41.1-56.6), and mean resting LES pressure was 11.9 (95%CI 11.4-12.5) mmHg. Overall, 62.3% of patients had a DeMeester score higher than 14.7 and 34% had a hypotensive LES. In the bivariate analysis, there was no correlation between DeMeester score and BMI, age or gender. Only 10% had signs of esophagitis or Barrett’s esophagus. DeMeester score was higher in patients with esophagitis (56.9±12.4 vs 47.9±4.1) although this difference was not statistically significant (P=0,48). Out of all patients, 64.4% had either an abnormal DeMeester score or erosive endoscopic signs. Non-erosive reflux disease (NERD) accounted for 54% of all patients and for 86.9% of patients with abnormal pH-metry.
Conclusions: Gastroesophageal reflux disease was diagnosed in 64.4% of patients under study for bariatric surgery. Endoscopy should not be relied on as the only diagnostic tool; as 87% of patients with abnormal pH-metry did not have esophagitis. This study suggests that GERD might be may be more prevalent than expected in the presurgical bariatric population.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87259
Program Number: P653
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster