Improvement in gastroesophageal reflux disease symptoms after various bariatric procedures

Review of the Bariatric Outcomes Longitudinal Database

Pradeep K. Pallati, Abhijit Shaligram, Valerie K. Shostrom, Dmitry Oleynikov, Corrigan L McBride, Matthew R Goede

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background The prevalence of gastroesophageal reflux disease (GERD) in the morbidly obese population is as high as 45%. The objective of this study was to compare the efficacy of various bariatric procedures in the improvement of GERD. Methods The Bariatric Outcomes Longitudinal Database is a prospective database of patients who undergo bariatric surgery by a participant in the American Society of Metabolic and Bariatric Surgery Center of Excellence program. GERD is graded on a 6-point scale, from 0 (no history of GERD) to 5 (prior surgery for GERD). Patients with GERD severe enough to require medications (grades 2, 3, and 4) from June 2007 to December 2009 are identified; the resolution of GERD is noted based on 6-month follow-up. Results Of a total of 116,136 patients, 36,938 patients had evidence of GERD preoperatively. After excluding patients undergoing concomitant hiatal hernia repair or fundoplication, there were 22,870 patients with 6-month follow-up. Mean age was 47.6±11.1 years, with an 82% female population. Mean BMI was 46.3±8.0 kg/m2. Mean preoperative GERD score for patients with Roux-en-Y gastric bypass (RYGB) was 2.80±.56, and mean postoperative score was 1.33±1.41 (P<.0001). Similarly, adjustable gastric banding (AGB, 2.77±.57 to 1.63±1.37, P<.0001) and sleeve gastrectomy (SG, 2.82±.57 to 1.85±1.40, P<.0001) had significant improvement in GERD score. GERD score improvement was best in RYGB patients (56.5%; 7955 of 14,078) followed by AGB (46%; 3773 of 8207) and SG patients (41%; 240 of 585). Conclusion All common bariatric procedures improve GERD. Roux-en-Y gastric bypass is superior to adjustable gastric banding and sleeve gastrectomy in improving GERD. Also, the greater the loss in excess weight, the greater the improvement in GERD score.

Original languageEnglish (US)
Pages (from-to)502-507
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume10
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Bariatrics
Gastroesophageal Reflux
Databases
Bariatric Surgery
Gastric Bypass
Gastrectomy
Stomach
Fundoplication
Hiatal Hernia
Herniorrhaphy

Keywords

  • Adjustable gastric banding
  • Bariatric Outcomes Longitudinal Database (BOLD)
  • Gastroesophageal reflux disease (GERD)
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery

Cite this

@article{d53028a955a143b88b0f4a28cffb759e,
title = "Improvement in gastroesophageal reflux disease symptoms after various bariatric procedures: Review of the Bariatric Outcomes Longitudinal Database",
abstract = "Background The prevalence of gastroesophageal reflux disease (GERD) in the morbidly obese population is as high as 45{\%}. The objective of this study was to compare the efficacy of various bariatric procedures in the improvement of GERD. Methods The Bariatric Outcomes Longitudinal Database is a prospective database of patients who undergo bariatric surgery by a participant in the American Society of Metabolic and Bariatric Surgery Center of Excellence program. GERD is graded on a 6-point scale, from 0 (no history of GERD) to 5 (prior surgery for GERD). Patients with GERD severe enough to require medications (grades 2, 3, and 4) from June 2007 to December 2009 are identified; the resolution of GERD is noted based on 6-month follow-up. Results Of a total of 116,136 patients, 36,938 patients had evidence of GERD preoperatively. After excluding patients undergoing concomitant hiatal hernia repair or fundoplication, there were 22,870 patients with 6-month follow-up. Mean age was 47.6±11.1 years, with an 82{\%} female population. Mean BMI was 46.3±8.0 kg/m2. Mean preoperative GERD score for patients with Roux-en-Y gastric bypass (RYGB) was 2.80±.56, and mean postoperative score was 1.33±1.41 (P<.0001). Similarly, adjustable gastric banding (AGB, 2.77±.57 to 1.63±1.37, P<.0001) and sleeve gastrectomy (SG, 2.82±.57 to 1.85±1.40, P<.0001) had significant improvement in GERD score. GERD score improvement was best in RYGB patients (56.5{\%}; 7955 of 14,078) followed by AGB (46{\%}; 3773 of 8207) and SG patients (41{\%}; 240 of 585). Conclusion All common bariatric procedures improve GERD. Roux-en-Y gastric bypass is superior to adjustable gastric banding and sleeve gastrectomy in improving GERD. Also, the greater the loss in excess weight, the greater the improvement in GERD score.",
keywords = "Adjustable gastric banding, Bariatric Outcomes Longitudinal Database (BOLD), Gastroesophageal reflux disease (GERD), Roux-en-Y gastric bypass, Sleeve gastrectomy",
author = "Pallati, {Pradeep K.} and Abhijit Shaligram and Shostrom, {Valerie K.} and Dmitry Oleynikov and McBride, {Corrigan L} and Goede, {Matthew R}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.soard.2013.07.018",
language = "English (US)",
volume = "10",
pages = "502--507",
journal = "Surgery for Obesity and Related Diseases",
issn = "1550-7289",
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T1 - Improvement in gastroesophageal reflux disease symptoms after various bariatric procedures

T2 - Review of the Bariatric Outcomes Longitudinal Database

AU - Pallati, Pradeep K.

AU - Shaligram, Abhijit

AU - Shostrom, Valerie K.

AU - Oleynikov, Dmitry

AU - McBride, Corrigan L

AU - Goede, Matthew R

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background The prevalence of gastroesophageal reflux disease (GERD) in the morbidly obese population is as high as 45%. The objective of this study was to compare the efficacy of various bariatric procedures in the improvement of GERD. Methods The Bariatric Outcomes Longitudinal Database is a prospective database of patients who undergo bariatric surgery by a participant in the American Society of Metabolic and Bariatric Surgery Center of Excellence program. GERD is graded on a 6-point scale, from 0 (no history of GERD) to 5 (prior surgery for GERD). Patients with GERD severe enough to require medications (grades 2, 3, and 4) from June 2007 to December 2009 are identified; the resolution of GERD is noted based on 6-month follow-up. Results Of a total of 116,136 patients, 36,938 patients had evidence of GERD preoperatively. After excluding patients undergoing concomitant hiatal hernia repair or fundoplication, there were 22,870 patients with 6-month follow-up. Mean age was 47.6±11.1 years, with an 82% female population. Mean BMI was 46.3±8.0 kg/m2. Mean preoperative GERD score for patients with Roux-en-Y gastric bypass (RYGB) was 2.80±.56, and mean postoperative score was 1.33±1.41 (P<.0001). Similarly, adjustable gastric banding (AGB, 2.77±.57 to 1.63±1.37, P<.0001) and sleeve gastrectomy (SG, 2.82±.57 to 1.85±1.40, P<.0001) had significant improvement in GERD score. GERD score improvement was best in RYGB patients (56.5%; 7955 of 14,078) followed by AGB (46%; 3773 of 8207) and SG patients (41%; 240 of 585). Conclusion All common bariatric procedures improve GERD. Roux-en-Y gastric bypass is superior to adjustable gastric banding and sleeve gastrectomy in improving GERD. Also, the greater the loss in excess weight, the greater the improvement in GERD score.

AB - Background The prevalence of gastroesophageal reflux disease (GERD) in the morbidly obese population is as high as 45%. The objective of this study was to compare the efficacy of various bariatric procedures in the improvement of GERD. Methods The Bariatric Outcomes Longitudinal Database is a prospective database of patients who undergo bariatric surgery by a participant in the American Society of Metabolic and Bariatric Surgery Center of Excellence program. GERD is graded on a 6-point scale, from 0 (no history of GERD) to 5 (prior surgery for GERD). Patients with GERD severe enough to require medications (grades 2, 3, and 4) from June 2007 to December 2009 are identified; the resolution of GERD is noted based on 6-month follow-up. Results Of a total of 116,136 patients, 36,938 patients had evidence of GERD preoperatively. After excluding patients undergoing concomitant hiatal hernia repair or fundoplication, there were 22,870 patients with 6-month follow-up. Mean age was 47.6±11.1 years, with an 82% female population. Mean BMI was 46.3±8.0 kg/m2. Mean preoperative GERD score for patients with Roux-en-Y gastric bypass (RYGB) was 2.80±.56, and mean postoperative score was 1.33±1.41 (P<.0001). Similarly, adjustable gastric banding (AGB, 2.77±.57 to 1.63±1.37, P<.0001) and sleeve gastrectomy (SG, 2.82±.57 to 1.85±1.40, P<.0001) had significant improvement in GERD score. GERD score improvement was best in RYGB patients (56.5%; 7955 of 14,078) followed by AGB (46%; 3773 of 8207) and SG patients (41%; 240 of 585). Conclusion All common bariatric procedures improve GERD. Roux-en-Y gastric bypass is superior to adjustable gastric banding and sleeve gastrectomy in improving GERD. Also, the greater the loss in excess weight, the greater the improvement in GERD score.

KW - Adjustable gastric banding

KW - Bariatric Outcomes Longitudinal Database (BOLD)

KW - Gastroesophageal reflux disease (GERD)

KW - Roux-en-Y gastric bypass

KW - Sleeve gastrectomy

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