 Gastroesophageal Reflux Disease (GERD)
What is it?
Gastroesophageal Reflux Disease is injury to the esophagus caused by chronic exposure to stomach acid. While the symptom of heartburn is often associated with this disease, GERD is more than an annoyance. It is a serious disease that can cause esophagitis, Barrett’s esophagus, and esophageal cancer. Occasional heartburn does not indicate GERD.
Excess body weight may weaken the valve at the top of the stomach, allowing acid to escape into the esophagus. This escape is known as gastroesophageal reflux. While GERD may occur regardless of someone’s age, gender, or body mass, the disease tends to be more severe in the obese.
A five-to 10-year follow-up study that included 16,191 participants showed that there is an independent relationship between obesity, nighttime GERD and habitual snoring, and the onset of asthma and respiratory symptoms in adults.11 A 130-patient study found that people who suffer from GERD experienced a worsening of symptoms as their weight increased.12
How is it affected by bariatric surgery?
Obesity increases a person’s risk of GERD. Bariatric surgery improves GERD by reducing the amount of stomach acid produced.
What success have patients found through bariatric surgery?
A 2000 study of 500 patients showed complete resolution of GERD in 98 percent of patients.8 While there is anti-reflux surgery, it fails more often in people with morbid obesity and only addresses one co-morbidity.13 Another study found that all participants who had gastric bypass surgery reported an improvement in or no symptoms of GERD.13
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References
8 Wittgrove AC, Clark GW. Laparoscopic Gastric Bypass, Roux-En-Y 500 Patients: Technique and Results, with 3-60 Month Follow-up. Obes Surg 2000 Jun;10(3):233-39.
11 Gunnbjornsdottir MI, Omenaas E, Gislason T, et al. Obesity and Nocturnal
Gastroesophageal Reflux are Related to Onset of Asthma and Respiratory Symptoms. Eur Respir 2004;24:116-121.
12 Smith SC, Edwards CB, Goodman GN. Symptomatic and Clinical Improvement in Morbidly Obese Patients with Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass. Obes Surg 1997;7:479-484.
13 Perry Y, Courcoulas AP, Fernando HC, et al. Laparoscopic Roux-En-Y Gastric Bypass for Recalcitrant Gastroesophageal Reflux Disease In Morbidly Obese Patients. J Lap Surg 2004 Jan-Mar;8(1):19-23. |
