title: Frequency of abnormal esophageal acid exposure in patients eligible for bariatric surgery.
abstract: BACKGROUND
  Obesity and gastroesophageal reflux disease (GERD) are both high-prevalence diseases in developed nations. Obesity has been identified as an important risk factor in the development of GERD. The objective of this study was to determine the frequency of abnormal esophageal acid exposure in patients candidate for bariatric surgery and its relationship with any clinical and endoscopic findings before surgery.
  
  
  METHODS
  Data collected from a group of 88 patients awaiting bariatric surgery included a series of demographic variables and symptoms typical of GERD. The tests patients underwent included manometry, pH monitoring, and upper gastrointestinal endoscopy. Univariate and multivariate analyses were conducted on the variables related to the onset of reflux.
  
  
  RESULTS
  Esophageal pH monitoring tests were positive in 65% of the patients. Manometries showed lower esophageal sphincter hypotonia in 46%, while 20% returned abnormal upper endoscopy results. Out of the 45% of patients who were asymptomatic or returned normal endoscopies, half returned positive esophageal pH tests. In turn, among the 55% of patients who had symptoms or an abnormal upper endoscopy, three quarters had pH tests that diagnosed reflux. pH tests were also positive in 80% of symptomatic patients and 100% of patients with esophagitis (P<.042). No statistically significant relationship was found between body mass index, sex, age, manometry, or hiatus hernia and the positive pH monitoring.
  
  
  CONCLUSIONS
  Frequency of abnormal esophageal acid exposure among obese patients is high. There is a relationship between the presence of symptoms and reflux. But the absence of symptoms does not rule out the presence of abnormal esophageal function tests.
authors.affiliation: Department of Surgery, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain.
authors.forename: Jesica
authors.initials: J
authors.lastname: Martín-Pérez
authors.affiliation: Department of Surgery, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain. Electronic address: ivanhuc@hispavista.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Arteaga-González
authors.affiliation: Department of Surgery, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Martín-Malagón
authors.affiliation: Department of Surgery, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain.
authors.forename: Hermógenes
authors.initials: H
authors.lastname: Díaz-Luis
authors.affiliation: Department of Digestive, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Casanova-Trujillo
authors.affiliation: Department of Surgery, University Hospital of Canarias (HUC), Santa Cruz de Tenerife, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Carrillo-Pallarés A
mesh_terms: D000328:Adult; D017677:Age Distribution; D050110:Bariatric Surgery / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D050782:Esophageal pH Monitoring; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome
keywords: Esophageal pH monitoring; Gastroesophageal reflux disease; Manometry; Obesity; Upper gastrointestinal endoscopy