title: The importance of upper gastrointestinal endoscopy in morbidly obese patients.
abstract: OBJECTIVE
  Obesity is an epidemic and its prevalence and number of patients underwent bariatric surgery continue to increase worldwide. This study aimed to evaluate endoscopic findings and co-morbidities, to investigate the prevalence of Helicobacter pylori (H. pylori) infection and the relationship between body mass index (BMI) and gastroesophageal sphincter incompetency in obese patients.
  
  
  METHODS
  An upper gastrointestinal system endoscopy and mucosal sampling were performed in all patients hospitalized for bariatric surgery. Age, gender, BMI, co-morbidities and endoscopic findings were recorded. Gastroesophageal sphincter incompetency was classified according to Hill classification. The patients were divided into two groups: group I, endoscopically normal and group II, endoscopically abnormal.
  
  
  RESULTS
  Total 127 patients were enrolled into prospective study. Of these, 93 (%73.2) were female and the mean age was 38.9±12.5 years (range: 16-68). Abnormal endoscopic findings and H. pylori were detected in 80.4% and 44.9% of patients, respectively. In group II, patients were older, BMI higher and H. pylori more prevalent (all statistically significant). Diabetes mellitus, hypertension and dyslipidemia were the most frequent common co-morbidities. Rate of multiple co-morbidities were more common in group II. Gastroesophageal sphincter incompetency in total group was observed in a rate of 46.5% and was weakly correlated with BMI.
  
  
  CONCLUSIONS
  Four-fifths of obese patients have at least one endoscopic abnormal finding, three fourth at least one co-morbidity and half H. pylori positivity. Upper gastrointestinal system endoscopy should be performed routinely in all patients to predict and prevent complications following bariatric surgery.
authors.affiliation: Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey. babbaysal@gmail.com.
authors.forename: Birol
authors.initials: B
authors.lastname: Baysal
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kayar
authors.forename: Ahmet
authors.initials: A
authors.lastname: Danalıoğlu
authors.forename: Tuba
authors.initials: T
authors.lastname: Özkan
authors.forename: Nuket Bayram
authors.initials: NB
authors.lastname: Kayar
authors.forename: Nurcan
authors.initials: N
authors.lastname: Ünver
authors.forename: Süleyman
authors.initials: S
authors.lastname: Bozkurt
authors.forename: Ali Tüzün
authors.initials: AT
authors.lastname: İnce
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D050110:Bariatric Surgery; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000473:pathology; D050171:Dyslipidemias / Q000453:epidemiology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods* / Q000706:statistics & numerical data; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult