title: The Impact of Gastric Bypass on Gastroesophageal Reflux Disease in Morbidly Obese Patients.
abstract: OBJECTIVE
  To assess the impact of Roux-en-Y gastric bypass (GBP) on gastroesophageal reflux disease (GERD) in morbidly obese patients.
  
  
  BACKGROUND
  Recently, authors have reported that early results of GBP can control GERD. However, longer follow-ups based on objective parameters for GERD are missing.
  
  
  METHODS
  Fifty-three patients [15 men (28%), 39 years old (range, 18-59), body mass index = 46 ± 7.7 kg/m2] were consecutively evaluated for GERD irrespectively of related symptoms, before the operation (E1) and at 6 (E2) and 39 ± 7 months postoperatively (E3). The end points were (1) esophageal syndromes based on the Montreal Consensus and (2) an esophageal acid exposure assessment.
  
  
  RESULTS
  Body mass index dropped from 46 ± 7.7 kg/m2 at E1 to 30 ± 5.2 kg/m2 at E3. Typical reflux syndrome displayed a significant decrease from 31 (58%) at E1 to 8 (15%) at E2 and 5 (9%) at E3. Statistically significant differences occurred between E1 and both postoperative evaluations (P < 0.001). Reflux esophagitis was detected in 24 (45%), 17 (32%), and 10 patients (19%) at E1, E2, and E3, respectively (P = 0.002). The incidence of GERD decreased in 34 (64%) and 21 (40%) patients at E1 and E2, respectively, and then in 12 (23%) patients at E3. DeMeester scores reduced from 28.6 (E1) to 9.4 (E2) and 1.2 (E3) (P < 0.001).
  
  
  CONCLUSIONS
  For most morbidly obese patients, in addition to causing significant weight loss, GBP reduces GERD symptoms, improves reflux esophagitis, and decreases esophageal acid exposure for longer than 3 years.
authors.affiliation: *Department of Surgery, GASTROBESE, Passo Fundo, RS, Brazil †Hospital Universitário São Vicente de Paulo, Passo Fundo, RS, Brazil ‡Post-Graduate Program in Surgery, School of Medicine, UFRGS, Porto Alegre, RS, Brazil §School of Medicine, Hospital de Clinicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil ¶Department of Statistics, UFRGS, Porto Alegre, RS, Brazil ||School of Medicine, Universidade de Passo Fundo, Passo Fundo, RS, Brazil.
authors.forename: Carlos Augusto S
authors.initials: CA
authors.lastname: Madalosso
authors.forename: Richard Ricachenevsky
authors.initials: RR
authors.lastname: Gurski
authors.forename: Sidia M
authors.initials: SM
authors.lastname: Callegari-Jacques
authors.forename: Daniel
authors.initials: D
authors.lastname: Navarini
authors.forename: Guilherme
authors.initials: G
authors.lastname: Mazzini
authors.forename: Marina da Silva
authors.initials: Mda S
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D055815:Young Adult