Introduction Gastro-oesophageal reflux disease (GORD) after bariatric surgery is a debated topic. This study investigated the prevalence of GORD and associated oesophageal complications following bariatric procedures—namely, adjustable gastric banding (AGB), sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB). Methods This was a prospective multicentre study designed to evaluate the long-term effects of bariatric surgery on GORD. Patients were studied at baseline, at >10 years following AGB, SG, and RYGB, and at >3 years following OAGB (due to the more recent recognition of OAGB as a standard bariatric procedure). Patients were assessed by endoscopy and GORD symptom evaluation. Results A total of 241 patients were enrolled. A minimum follow-up of 10 years was completed by 193 patients following AGB (57 patients), SG (95 patients), and RYGB (41 patients), and of >3 years by 48 subjects following OAGB. GORD symptoms increased following AGB and SG (from 14 to 31.6 per cent and from 26.3 to 58.9 per cent, respectively; P < 0.0001), improved following RYGB (from 36.6 to 14.6 per cent; P < 0.0001), and were unchanged following OAGB. The overall prevalence of erosive oesophagitis was greater in the SG group (74.7 per cent) than in the AGB (42.1 per cent), RYGB (22 per cent), and OAGB (22.9 per cent) groups (P < 0.0001). Barrett’s oesophagus was found only in patients who had SG (16.8 per cent). Biliary-like gastric stagnation was found in a greater proportion of SG and OAGB patients (79.7 and 69.4 per cent, respectively) than in other treatment groups (P < 0.0001). The prevalence of biliary-type reflux into the oesophagus was higher in patients who underwent SG (74.7 per cent), compared with other treatment groups. Conclusion Bariatric surgery leads to gastro-oesophageal complications of variable severity, particularly SG, which can result in a large proportion of patients developing Barrett’s oesophagus.

In 2016, 39% of adults were overweight, and about 13% of the world's adult population were obese. Obesity represents a growing global public health despite the availability of diet and lifestyle counseling, pharmacologic therapy, and bariatric surgery. Endoscopic bariatric therapies (EBTs) encompass a wide range of devices requiring flexible endoscopy for placement or removal and procedures performed via flexible endoscopy for the treatment of obesity. Current primary EBTs can be classified as space-occupying or non-space-occupying devices (restrictive, bypass, or aspiration therapy).Intragastric balloons (IBG) act as space-occupying devices, reducing stomach capacity and inducing satiety by several mechanisms. To date, ORBERA ® Intragastric Balloon System, RESHAPE DUO Intragastric Balloon, and OBALON Balloon System are approved by the US Food and Drug Administration (FDA) based on demonstrated safety and efficacy in randomized controlled trials (RCTs). Two other balloons are currently under FDA investigation: the

In 2016, 39% of adults were overweight, and about 13% of the world's adult population were obese. Obesity represents a growing global public health despite the availability of diet and lifestyle counseling, pharmacologic therapy, and bariatric surgery. Endoscopic bariatric therapies (EBTs) encompass a wide range of devices requiring flexible endoscopy for placement or removal and procedures performed via flexible endoscopy for the treatment of obesity. Current primary EBTs can be classified as space-occupying or non-space-occupying devices (restrictive, bypass, or aspiration therapy).Intragastric balloons (IBG) act as space-occupying devices, reducing stomach capacity and inducing satiety by several mechanisms. To date, ORBERA ® Intragastric Balloon System, RESHAPE DUO Intragastric Balloon, and OBALON Balloon System are approved by the US Food and Drug Administration (FDA) based on demonstrated safety and efficacy in randomized controlled trials (RCTs). Two other balloons are currently under FDA investigation: the