title: Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-band system implantation.
abstract: BACKGROUND
  The relation between gastro-esophageal reflux disease (GERD) and obesity is controversial. The laparoscopic adjustable gastric band (LAGB) procedure is effective for morbid obesity. Its indication in the presence of GERD, however, is still debated. This study aimed to investigate esophageal symptoms, motility patterns, and acid exposure in morbidly obese patients before and after LAGB placement.
  
  
  METHODS
  For this study, 43 consecutive obese patients were investigated by a standardized symptoms questionnaire, stationary manometry and 24-h ambulatory pH-metry, and 16 patients with abnormal esophageal acid exposure were reevaluated 18 months after LAGB placement.
  
  
  RESULTS
  Symptom scores and abnormal esophageal acid exposure were found to be significantly higher, Lower Esophageal Sphincter (LOS) pressure was significantly lower in obese patients than in control subjects. After LAGB, esophageal acid exposure was significantly reduced in all but two patients, who presented with proximal of gastric pouch dilation.
  
  
  CONCLUSIONS
  There is a high prevalence of GERD in the obese population. Uncomplicated LAGB placement reduces the amount of acid in these patients with abnormal esophageal acid exposure.
authors.affiliation: Dipartimento di Chirurgia Generale, Geriatrica, Oncologica e Tecnologic Avanzate e, Università Federico II, Napoli, Italy. piovino@unina.it
authors.forename: P
authors.initials: P
authors.lastname: Iovino
authors.forename: L
authors.initials: L
authors.lastname: Angrisani
authors.forename: F
authors.initials: F
authors.lastname: Tremolaterra
authors.forename: E
authors.initials: E
authors.lastname: Nirchio
authors.forename: M
authors.initials: M
authors.lastname: Ciannella
authors.forename: V
authors.initials: V
authors.lastname: Borrelli
authors.forename: F
authors.initials: F
authors.lastname: Sabbatini
authors.forename: G
authors.initials: G
authors.lastname: Mazzacca
authors.forename: C
authors.initials: C
authors.lastname: Ciacci
mesh_terms: D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis; D004935:Esophageal Diseases / Q000175:diagnosis / Q000601:surgery; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000601:surgery; D004947:Esophagus / Q000737:chemistry* / Q000473:pathology*; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000601:surgery; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D019736:Prostheses and Implants; D011795:Surveys and Questionnaires