title: Esophageal abnormalities in morbidly obese adult patients.
abstract: BACKGROUND
  An increase in body mass index has been found to be associated with an increase in the prevalence of gastroesophageal reflux disease (GERD) symptoms, esophageal mucosal injury, and GERD complications. Few systematic studies with objective tests have evaluated esophageal disorders in the morbidly obese population.
  
  
  OBJECTIVE
  To define more precisely in morbidly obese people the incidence of esophageal symptoms and characterize the esophageal disorders using objective data.
  
  
  METHODS
  University Hospital, Spain.
  
  
  METHODS
  Two hundred twenty-four presurgical morbidly obese patients were submitted to a protocol including a clinical history and objective tests (endoscopy, stationary esophageal manometry, 24-hour esophageal pH monitoring and isotopic emptying of the esophagus).
  
  
  RESULTS
  In a morbidly obese population, heartburn (50.9%) and regurgitation (28.6%) were the most prevalent symptoms of GERD. Endoscopy registered hiatus hernia (12.5%) and reflux esophagitis (17.3%). Manometry was often abnormal (33.4%), with a hypotensive lower esophageal sphincter as the most common finding. Esophageal pH-metry was abnormal in 54.2% of the cases. Finally, 9.1% of the patients presented with abnormal isotopic esophageal emptying. A correlation between the degree of obesity and the severity of symptoms/objective tests for esophageal abnormalities could not be found.
  
  
  CONCLUSIONS
  In morbidly obese patients, GERD is common, symptoms are unspecific, and there is a high prevalence of pH-metry and manometric abnormalities, unrelated to the degree of obesity.
authors.affiliation: Department of Digestive Diseases, University Clinic Hospital, University of Valencia, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mora
authors.affiliation: Department of Surgery, Unit of Bariatric Surgery, University Clinic Hospital, University of Valencia, Valencia, Spain.
authors.forename: Norberto
authors.initials: N
authors.lastname: Cassinello
authors.affiliation: Department of Digestive Diseases, University Clinic Hospital, University of Valencia, Valencia, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Mora
authors.affiliation: Department of Digestive Diseases, University Clinic Hospital, University of Valencia, Valencia, Spain.
authors.forename: Maia
authors.initials: M
authors.lastname: Bosca
authors.affiliation: Department of Digestive Diseases, University Clinic Hospital, University of Valencia, Valencia, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Minguez
authors.affiliation: Department of Surgery, Unit of Bariatric Surgery, University Clinic Hospital, University of Valencia, Valencia, Spain. Electronic address: joaquin.ortega@uv.es.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Ortega
mesh_terms: D000293:Adolescent; D000328:Adult; D004384:Duodenoscopy / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D004935:Esophageal Diseases / Q000150:complications* / Q000503:physiopathology; D004942:Esophagitis, Peptic / Q000209:etiology; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000503:physiopathology; D005769:Gastrointestinal Motility / Q000502:physiology; D006551:Hernia, Hiatal / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
keywords: 24-hour pH monitoring; Endoscopy; Esophageal motility; Gastroesophageal reflux disease (GERD); Isotopic emptying; Morbid obesity