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

Video Transcription

Video Summary

In this video, Barham Abudaye from the Mayo Clinic discusses reflux and dysmotility in bariatric patients. He starts by highlighting the increasing prevalence of obesity and the corresponding rise in bariatric procedures such as laparoscopic sleeve gastrectomy. Abudaye explains that obesity is a significant risk factor for foregut physiology disorders, including dysphagia and reflux, with increased acid exposure time and an elevated risk of esophageal cancer. He discusses the three components of the anti-reflux barrier: the lower esophageal sphincter, the diaphragmatic hiatus, and the gastroesophageal flap valve. Abudaye then delves into the impact of bariatric surgery on foregut physiology, showing that both laparoscopic sleeve gastrectomy and roux-en-Y gastric bypass can lead to dysphagia and increased acid exposure. He also introduces the phenomenon of post-obesity surgery esophageal dysfunction, characterized by increased afterload on the esophagus and potential complications such as hiatal hernia and erosive esophagitis. Abudaye concludes by discussing the use of endoscopic management, such as the TIF procedure and endoscopic sleeve gastroplasty, as potential solutions for treating reflux and obesity simultaneously. He notes that this is an area of ongoing research with significant unmet needs.

Asset Subtitle

Barham Abu Dayyeh

Keywords

reflux

dysmotility

bariatric patients

laparoscopic sleeve gastrectomy

foregut physiology disorders

endoscopic management