Esophageal motility disorders in the morbidly obese population

Koppman, John; Poggi, Luis; Szomstein, Samuel; Ukleja, Andrew; Botoman, Alin V.; Rosenthal, Raúl J.

doi:10.1007/s00464-006-9102-y

Cited by 128 publications

(70 citation statements)

References 31 publications

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“…Furthermore, obe sity might cause increased intraabdominal pressure that results in extrinsic gastric compression by visceral fat, with a subsequent increase in intragastric pressure and the gastroesophageal pressure gradient [36] , as well as an increased risk for developing a hiatal hernia [3740] . In obese patients, other factors that play a role in the pathophy siology of GERD are esophageal peristaltic abnormalities, such as malfunction of the lower esophageal sphincter, nu tcracker esophagus and nonspecific motility disorders [41] .…”

Section: Mechanical Factors: the Role Of Obesitymentioning

confidence: 99%

Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Ierardi

Rosania²,

Principe³

et al. 2010

WJGP

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The aim of this Editorial is to describe the growing possibility of a link between gastro-esophageal reflux disease (GERD) and metabolic syndrome on the light of recent epidemiological and pathophysiological evidence. The state of the art of GERD is described, based on recent definitions, pathophysiological evidence, epidemiology in developed countries, clinical subtypes together with a diagnostic approach specifically focussed on the appropriateness of endoscopy. Metabolic syndrome is accurately defined and the pivotal role of in sulin resistance is emphasized. The strong relationship between GERD and metabolic syndrome has been pathophysiologically analyzed, taking into account the role of obesity, mechanical factors and metabolic changes. Data collected by our group regarding eating habits and GERD are briefly summarized at the end of a pathophysiological analysis. The literature on the subject strongly supports the possibility that lifestyle and eating habits may be involved in both GERD and metabolic syndrome in developed countries.

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Section: Mechanical Factors: the Role Of Obesitymentioning

confidence: 99%

Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Ierardi

Rosania²,

Principe³

et al. 2010

WJGP

View full text Add to dashboard Cite

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“…The increase in intragastric pressure may cause impairment of esophageal peristalsis (25) . Although it is possible to see alterations in esophageal motility in obese subjects (16,20) , the swallowing dynamics does not differ between them and normal BMI subjects (3) , indicating that a possible increase in intragastric pressure of non-operated obese subjects is not sufficient to change swallowing and should not be an explanation for the alterations seen after the surgery.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of liquid ingestion after bariatric surgery

Dantas

Alves

Cassiani

et al. 2011

Arq. Gastroenterol.

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-Context -Bariatric surgery is an effective treatment for obesity; however, after surgery the patient may have difficulty in swallowing liquid and solid foods. Objectives -To evaluate liquid ingestion in patients who had undergone bariatric surgery. Method -We studied 43 volunteers with normal body mass index (BMI) (BMI: 18.5-24.9 kg/m 2 ), 55 subjects with class III obesity (BMI: >40.0 kg/m 2 ), and 48 subjects with bariatric surgery for treatment of class III obesity. The method chosen for evaluation was the water swallowing test. The subjects drank in triplicate 50 mL of water while being precisely timed and the number of swallows were counted. Results -There was no difference between subjects with normal BMI and subjects with class III obesity. During the first 2 months after bariatric surgery the patients showed an increase in the time needed to drink the entire volume, in the number of swallows, and in the inter-swallow interval, and a decrease in the volume swallowing capacity (volume/swallowing) and swallowing flow rate (volume swallowed/second). After 2 months, the results of the swallowing measurements moved in the direction of normal values. Conclusion -Bariatric surgery may cause more intense alterations of liquid bolus swallowing within 2 months after the procedure, which moved to normal values after this time. HEADINGS -Drinking. Bariatric surgery. Obesity.

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“…Los trastornos motores esofágicos producen dificultad en la alimentación por lo que es rara su presentación en obesos mórbidos 1 . Sin ser la obesidad un factor de riesgo para su presentación, se ha descrito una incidencia mayor a 50% de estos trastornos en manometrías de obesos mórbidos, en los que la acalasia corresponde sólo a un 0,5-1% de los casos [1][2][3] . Se debe considerar que estos trastornos tienden a producir baja de peso en poblaciones no obesas, por lo tanto, es rara la presentación simul-tánea de ambas patologías.…”

Section: Introductionunclassified

Acalasia en obesos mórbidos: Reporte de casos

et al. 2010

Rev Chil Cir

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Achalasia in morbidly obese patients. Report of two casesAchalasia is uncommon in morbidly obese patients. We report two patients with both conditions. A 71 years old diabetic male with a body mass index (BMI) of 36 kg/m 2 . He consulted for dysphagia and a manometry showed a lack of relaxation of the lower esophageal sphincter. He was subjected to unsuccessful pneumatic dilatations in two occasions. Finally the patient was subjected to a total gastrectomy and Roux en Y esophago-jejunal anastomosis. Eight months after surgery the patient reports slight dysphagia and lost 24 kg. A 66 years old male with a BMI of 44 kg/m 2 consulting for regurgitation. Manometry confirmed the diagnosis of achalasia. The patient was subjected to a esophagomyotomy, subtotal gastrectomy and Roux en Y gastro jejunal and jejuno-jejunal anastomosis. Two years after surgery the patient had a slight dysphagia and lost 20 kg.Key words: Achalasia, morbid obesity, gastrectomy. ResumenLa acalasia es un trastorno de la motilidad esofágica que tiende a producir baja de peso, siendo rara su presentación en obesos mórbidos. Existen pocos reportes de casos en la literatura. Se presentan 2 casos de pacientes con el diagnóstico de acalasia y obesidad mórbida, uno de ellos tratado con Gastrectomía total y el otro con Esofagomiotomía asociada a Bypass gástrico. Ambos pacientes evolucionaron en buenas condiciones. Finalmente se realiza un análisis de la literatura.Palabras clave: Obesidad mórbida, acalasia, cirugía. CASOS CLÍNICOS IntroducciónActualmente la obesidad es una epidemia a nivel mundial siendo la cirugía una de las mejores alternativas terapéuticas. Los trastornos motores esofágicos producen dificultad en la alimentación por lo que es rara su presentación en obesos mórbidos 1 . Sin ser la obesidad un factor de riesgo para su presentación, se ha descrito una incidencia mayor a 50% de estos trastornos en manometrías de obesos mórbidos, en los que la acalasia corresponde sólo a un 0,5-1% de los casos [1][2][3] . Se debe considerar que estos trastornos tienden a producir baja de peso en poblaciones no obesas, por lo tanto, es rara la presentación simul-

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Esophageal motility disorders in the morbidly obese population

Cited by 128 publications

References 31 publications

Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Evaluation of liquid ingestion after bariatric surgery

Acalasia en obesos mórbidos: Reporte de casos

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