The effect of Roux-en-Y gastric bypass on gastroesophageal reflux disease in morbidly obese Chinese patients.
BACKGROUND
The prevalence of gastroesophageal reflux disease (GERD) is increasing in Eastern and Western countries. Obesity is recognized as a risk factor of gastroesophageal reflux disease. However, little information is available on the prevalence of gastroesophageal reflux disease in morbidly obese Chinese patients. The aim of this study was to compare the prevalence of GERD in Chinese patients with morbid obesity and age- and sex-matched controls, and we also assessed the effect of Roux-en-Y gastric bypass on reflux symptoms and erosive esophagitis.


METHODS
Between November 2006 and February 2008, 150 morbidly obese Chinese patients underwent laparoscopic Roux-en-Y gastric bypass. Gastroesophageal reflux disease questionnaires and esophagogastroduodenoscopy results were assessed in all cases before surgery. The prevalence of reflux symptoms and erosive esophagitis was compared with the prevalence in a database of 300 age- and sex-matched controls. We also compared baseline and postoperative characteristics at 12 months after operation.


RESULTS
Patients with morbid obesity had higher frequencies of reflux symptoms (16% vs. 8%, P = 0.01) and erosive esophagitis (34% vs. 17%, P < 0.01) than those of controls. Twelve months after laparoscopic Roux-en-Y gastric bypass, 26 patients received follow-up evaluations. In addition to substantial weight loss, the prevalence of reflux symptoms and erosive esophagitis decreased significantly after operation (19.2% vs. 0%, P = 0.05, and 42.3% vs. 3.8%, P < 0.01, respectively).


CONCLUSIONS
Gastroesophageal reflux disease is pervasive in Chinese patients with morbid obesity and Roux-en-Y gastric bypass substantially improves not only the reflux symptoms but also the erosive esophagitis.
Department of Internal Medicine, E-DA Hospital and I-Shou University, 1, E-Da Rd., Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan.
Chi-Ming
CM
Tai
Yi-Chia
YC
Lee
Ming-Shiang
MS
Wu
Chi-Yang
CY
Chang
Ching-Tai
CT
Lee
Chih-Kun
CK
Huang
Hsin-Chih
HC
Kuo
Jaw-Town
JT
Lin
D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China; D015331:Cohort Studies; D004942:Esophagitis, Peptic / Q000208:ethnology* / Q000473:pathology; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000208:ethnology* / Q000473:pathology; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult