ASGE Esophagology: Tailoring Management from Testing to Treatment (Live and Virtual) | July 2022-Abu Dayyeh_Reflux and Dysmotility in Bariatric Setting

Abu Dayyeh_Reflux and Dysmotility in Bariatric Setting

Pdf Summary

This document discusses the connection between reflux and dysmotility in the bariatric setting. It highlights the prevalence of obesity in the US and the high percentage of bariatric surgeries being performed. The document also explores the relationship between GERD and obesity, discussing how BMI is linked to esophageal acid exposure and the incidence of erosive esophagitis and adenocarcinoma. Additionally, it examines the impact of bariatric surgery on reflux physiology, showing that both sleeve gastrectomy and RYGB can lead to altered esophageal clearance and changes in pH levels. The document further delves into the long-term consequences of high pressure exposure and the development of dysphagia in post-bariatric surgery patients. It also discusses the use of fundoplication and hiatal hernia repair in these patients, as well as the limitations and potential negative consequences of traditional anti-reflux surgery in individuals with obesity. The need for novel therapeutics to manage GERD and esophageal dysfunction in obese patients is highlighted. Overall, the document emphasizes the importance of understanding and addressing reflux and dysmotility in the bariatric setting to improve patient outcomes.

Keywords

reflux

dysmotility

bariatric setting

obesity

GERD

bariatric surgery

esophageal clearance

dysphagia

fundoplication

hiatal hernia repair