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Increase in gastroesophageal reflux disease symptoms and erosive esophagitis 1 year after laparoscopic sleeve gastrectomy among obese adults

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Abstract

Background

Although laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. This study evaluated the changes of GERD symptoms and erosive esophagitis (EE) in severely obese patients who underwent LSG.

Methods

Forty-seven severely obese women and 19 severely obese men (mean age of 37.2 ± 12.7 years) who underwent LSG between August 2007 and November 2009 were enrolled. All patients completed the Reflux Disease Questionnaire and underwent esophagogastroduodenoscopy preoperatively and at least 1 year after LSG.

Results

The median follow-up period was 12 months (range, 12–21). After surgery, significant decreases were reported in mean body mass index (36.3 ± 4.1 vs. 25.8 ± 2.9 kg/m2), mean waist circumference (109.5 ± 12.8 vs. 85.7 ± 9.5 cm), and prevalence of metabolic syndrome (54.5 vs. 7.6 %; P < 0.001 for both). Conversely, a significant increase was observed in the prevalence of GERD symptoms (12.1 vs. 47 %) and EE (16.7 vs. 66.7 %) after LSG (P < 0.001 for both). The prevalence of hiatal hernias also increased significantly (6.1 vs. 27.3 %; P < 0.001) after LSG, and it was significantly higher in patients with than those without EE after LSG (9.1 vs. 36.4 %, respectively; P = 0.02).

Conclusions

Although LSG can achieve significant weight loss and improvement of comorbidities in severely obese patients, the prevalence and severity of GERD symptoms and EE increase after the operation. The occurrence of EE after LSG is related to the presence of a hiatal hernia after the operation.

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Acknowledgments

This study was supported by a Project of the E-Da Hospital, Grant Number EDAHP100031.

Disclosures

Chi-Ming Tai, Chih-Kun Huang, Yi-Chia Lee, Chi-Yang Chang, Ching-Tai Lee, and Jaw-Town Lin have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Bariatric and Metabolic International Surgery Center, E-Da Hospital, Kaohsiung, Taiwan, ROC

    Chi-Ming Tai & Chih-Kun Huang

  2. Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC

    Chi-Ming Tai

  3. Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan, ROC

    Chi-Ming Tai, Chi-Yang Chang & Ching-Tai Lee

  4. Department of Surgery, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan, ROC

    Chih-Kun Huang

  5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC

    Yi-Chia Lee

  6. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC

    Jaw-Town Lin

  7. Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan, ROC

    Jaw-Town Lin

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  1. Chi-Ming Tai
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  2. Chih-Kun Huang
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Correspondence to Jaw-Town Lin.

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Tai, CM., Huang, CK., Lee, YC. et al. Increase in gastroesophageal reflux disease symptoms and erosive esophagitis 1 year after laparoscopic sleeve gastrectomy among obese adults. Surg Endosc 27, 1260–1266 (2013). https://doi.org/10.1007/s00464-012-2593-9

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  • DOI: https://doi.org/10.1007/s00464-012-2593-9

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