Setthasiri Pantanakul, Chotirot Angkurawaranon, Ratchamon Pinyoteppratarn, Poochong Timrattana. Rajavithi Hospital
Background: Obesity is an important health problem affecting more than 500 million people worldwide. Esophageal dysmotility is a gastrointestinal pathology associated with obesity; however, its prevalence and characteristics remain unclear. Esophageal dysmotilities have a high prevalence among obese patients regardless of gastrointestinal symptoms.
Objective: To identify the prevalence of esophageal motility disorder in asymptomatic obese patient.
Materials and Methods: Prospective study was performed between June 2014 to March 2017. A total of 47 of morbid obese patients who visited the bariatric and metabolic clinic at Rajavithi Hospital (Bangkok, Thailand) underwent preoperative evaluation with high resolution esophageal manometric test with ManoscanTM eso (Smith medical). Tracings were retrospective analysis and reviewed according to Chicago classification criteria for esophageal motility disorders.
Results: Among 47 asymptomatic obese participants, twenty five of them were female. The mean age was 32.94 (16-68) years old. Most of the participants were classified as class three obesity or over. The mean BMI was 53.83 Kg./m2 . No hiatal hernia was found and the anatomy of esophagus was normal in all patients. The mean IRP was 14.59 mmHg. Twenty-one patients (44.68%) demonstrated high IRP over normal limit (>15 mmHg). Four patients demonstrated premature contraction (DL<4.5 second). Hypercontractile esophagus was identified in 2 patients and ineffective motility disorder was found in 5 patients. Two patients were diagnosed as distal esophageal spasm (DES). Two patients were compatible with type 3 achalasia and 19 patients (40.42%) have esophageal outflow obstruction. None of the patient demonstrate incomplete bolus clearance even high IRP or abnormal motility.
Conclusion: This study reveals a high prevalence of esophageal dysmotility in asymptomatic Thai obese patients. The most common abnormality were esophageal outflow obstruction and ineffective motility. The Chicago classification of esophageal motility disorder may not suitable among obese population.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86686
Program Number: P550
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster