Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

Overview

Journal Obes Surg

Date 2019 Jun 16

PMID 31201693

Citations 13

Authors

Ivan Kristo

Matthias Paireder

Gerd Jomrich

Daniel M Felsenreich

Milena Nikolic

Felix B Langer

Gerhard Prager

Sebastian F Schoppmann

Affiliations

Soon will be listed here.

Abstract

Background: The implementation of high-resolution manometry (HRM) and the Lyon Consensus statement facilitate evaluation of gastroesophageal reflux disease and motility disorders in morbidly obese patients. Therefore, we aimed to investigate prevalence and phenotype of (borderline) GERD and esophageal motility disorders in this population.

Methods: Consecutive morbidly obese (BMI ≥ 35 kg/m) patients were offered evaluation by means of HRM, ambulatory 24-h pH impedance monitoring, endoscopy, and a clinical examination at our tertiary academic center. Data were collected prospectively.

Results: Out of 448 eligible individuals, 147 patients (females = 75, 51%) with a median age of 41.6 (33.4; 52.3) years and a BMI of 44 (40.9; 49.4) kg/m were included during the study period. The Chicago Classification revealed motility disorders in 50 (34%) patients, dominated by outflow obstruction (18.4%, n = 27) and a novel disorder (7.5%, n = 11), nicknamed jackhammer esophagus (JE). According to the Lyon Consensus, 52 (35.4%) patients had evidence of true GERD, whereas borderline GERD was noted in another 60 (40.8%). Hypersensitive esophagus was observed in 6.8% (n = 10). Sensitivity and specificity of symptoms for GERD were 53.8% and 68.4%, respectively.

Conclusions: The current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE in obesity and to identify risk factors for adverse outcomes following bariatric surgery.

Citing Articles

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Higher obesity class is associated with more severe esophageal symptoms and reflux burden but not altered motor function or contractile reserve.

Hiramoto B, Redd W, Muftah M, Jonnadula S, Okwara N, Jenkins A Neurogastroenterol Motil. 2023; 36(1):e14691.

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Effect of Body Weight and Obesity on Esophageal Function.

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