Upper Gastrointestinal Symptoms and Associated Disorders in Morbidly Obese Patients: A Prospective Study

Abstract

These observations suggest a significant increase in the frequency of heartburn, hiatal hernia, and histologically identified gastritis in morbidly obese patients.

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

“…Dutta et al (11) found prevalence of gastric ulcer of 2.9%, identified histologically gastritis in 23.7% and H. pylori in 6.9% in the obese patients, finding that was not different from the control (non-obese) patients.…”

“…Eradication of the H. pylori as a routine in the preoperative of bariatric surgery is still debated and scarce researches were performed in regards the histology of gastric mucosa (2,7,11,23,25,26,30,33,34,35) . Mong et al (25) studied 272 patients who were candidates to bariatric surgery, in which 33 (12%) showed lesions in the upper digestive tract.…”

“…A review of the literature revealed that the preoperative prevalence of H. pylori ranges from 6.9% to 61.3% in obese patients undergoing bariatric surgery (2,11,12,19,23,29,30,32,38) . In the present study, there were 73 (57.9%) cases with abnormalities in upper digestive endoscopy and 53 (42.1%) patients with normal UGI.…”

Does concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair increase morbidity?

“…In a study of Dutta et al, it was observed that reflux symptoms, endoscopically and histologically detected gastritis, and endoscopically detected hiatal hernia were more frequent in morbidly obese patients [8]. In two different studies by Pandolfino et al and Lee et al, it was reported that increased intragastric pressure and gastroesophageal pressure gradients increased the risk of hiatal hernia in direct proportion to increased BMI [13,14].…”

“…Obesity is also an independent risk factor for gastroesophageal reflux disease. Obesity not only leads to susceptibility to gastroesophageal reflux disease but also is itself an important independent risk factor for the development of hiatal hernia [4][5][6][7][8]. A coexisting hiatal hernia is found in half of obese patients with gastroesophageal reflux disease symptoms.…”