[Pathological gastroesophageal reflux in patients with severe, morbid and hyper obesity].

BACKGROUND

Overweight can be a risk factor for pathological gastroesophageal reflux or hiatal hernia.

OBJECTIVE

To study the prevalence of gastroesophageal reflux in patients with severe obesity.

METHODS

Sixty seven patients, 51 female, aged 17 to 56 years old with a body mass index over 35 kg/m2, were studied. An upper gastrointestinal endoscopy was performed in all, esophageal manometry was done in 32 and 24 h pH monitoring was done in 32 patients.

RESULTS

Seventy nine percent of patients complained of heartburn and 66% of regurgitation. In 16 patients, endoscopy was normal. An erosive esophagitis was found in 33 patients, a short columnar epithelium in 12 and a Barret esophagus with intestinal metaplasia in six. Normal endoscopic findings and erosive esophagitis were present with a higher frequency in women. No association between the degree of obesity and esophageal lesions was observed. Lower esophageal sphincter pressure and abdominal length were significantly higher in subjects with a body mass index over 50 compared to those with a body mass index between 35 and 39.9 kg/m2. No differences were observed in 24 h pH monitoring.

CONCLUSIONS

A high proportion of severely obese patients had symptoms and endoscopical findings of pathological gastroesophageal reflux.