title: Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study.
abstract: OBJECTIVE
  To prospectively evaluate the frequency of upper gastrointestinal symptoms and associated disorders in morbidly obese patients with endoscopy and histology prior to their gastric bypass surgery in comparison with age- and sex-matched nonobese control subjects.
  
  
  METHODS
  All patients who were scheduled to undergo laparoscopic gastric bypass for treatment of morbid obesity (body mass index, BMI > 40 kg/m(2)) during a 1-year period (n = 101) were included in the study. Age- and sex-matched nonobese patients who were seen in the medical clinics during the study period were enrolled as control subjects. The demographic data, total body weight, body mass index, and gastrointestinal symptoms were recorded, and the results of upper endoscopy and histology were tabulated. Endoscopic documentation of hiatal hernia, esophagitis, gastritis, gastric polyps, and peptic ulcer disease was also noted along with the histologic findings of the mucosal biopsies from the upper gastrointestinal tract.
  
  
  RESULTS
  The prevalence of heartburn as a symptom was significantly higher (P < 0.05) in the morbidly obese patients (32.6%) compared with in the control group (18.8%). Endoscopically, the prevalence of hiatal hernia was also significantly higher (P < 0.05) in the morbidly obese group (38.6%) compared with in the control group (13.8%). Similarly the frequency of endoscopically and histologically identified gastritis was significantly higher (P < 0.01) in the morbidly obese patient group. However, the frequency of histologically identified Helicobacter pylori was not statistically different in the two groups.
  
  
  CONCLUSIONS
  These observations suggest a significant increase in the frequency of heartburn, hiatal hernia, and histologically identified gastritis in morbidly obese patients.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA. sdutta@lifebridgehealth.org
authors.forename: Sudhir K
authors.initials: SK
authors.lastname: Dutta
authors.forename: Manish
authors.initials: M
authors.lastname: Arora
authors.forename: Agrawal
authors.initials: A
authors.lastname: Kireet
authors.forename: Hany
authors.initials: H
authors.lastname: Bashandy
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gandsas
mesh_terms: D000328:Adult; D005260:Female; D005756:Gastritis / Q000150:complications*; D006356:Heartburn / Q000150:complications*; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D055815:Young Adult