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

Video Transcription

Video Summary

In this video, Barham Abudaye from the Mayo Clinic discusses the topic of reflux and dysmotility in bariatric patients. He begins by acknowledging that this is a hot topic and that he will do his best to provide information on the subject. He then presents slides that show the impact of obesity on foregut physiology, particularly in relation to reflux. He explains that obesity is a risk factor for reflux and that bariatric procedures, such as laparoscopic sleeve gastrectomy and Rho-Y gastric bypass, can further affect foregut physiology and contribute to reflux symptoms. He discusses the role of the anti-reflux barrier, which consists of the lower esophageal sphincter, the diaphragmatic hiatus, and the gastroesophageal flap valve. Abudaye also presents findings from studies on the impact of bariatric surgery on foregut physiology, such as changes in lower esophageal sphincter pressure, esophageal amplitude contraction, and peristalsis. He discusses the development of a new entity called post-obesity surgery esophageal dysfunction, which is characterized by poor relaxation of the gastroesophageal junction and other abnormalities on endoflip and high-resolution manometry. Abudaye also highlights the role of hiatal hernia in contributing to reflux and discusses potential future directions in the endoscopic management of reflux and obesity. Overall, the video provides insights into the complexities of reflux and dysmotility in bariatric patients and highlights the need for novel therapeutic approaches.

Asset Subtitle

Dr. Barham Abu Dayyeh

Keywords

reflux

dysmotility

bariatric patients

obesity

foregut physiology

laparoscopic sleeve gastrectomy