Gastroesophageal Reflux Disease After Roux-en-Y Gastric Bypass: Pathophysiology and Management.
Manuela Monrabal LezamaCamila Bras HarriottFernando A M HerbellaFrancisco SchlottmannPublished in: Journal of laparoendoscopic & advanced surgical techniques. Part A (2023)
Introduction: Patients with obesity are often affected by gastroesophageal reflux disease (GERD). Roux-en-Y gastric bypass (RYGB) is considered the ideal operation for patients with severe obesity and GERD. Although the majority of patients improve their reflux with the operation, some might persist symptomatic and others can even develop de novo GERD. The aim of this study was to determine pathophysiologic factors involved in the development of GERD after RYGB surgery and define potential treatments for this condition. Materials and Methods: Studies including patients with GERD before and after RYGB and/or analyzing possible GERD therapies were analyzed by the authors. Searches were conducted in PubMed, Cochrane Library, and Embase databases. Results: GERD can persist, worsen, or develop after RYGB. There are certain technical elements of the operation identified as potential risk factors for GERD. Medical therapy is effective in the majority of patients. Both endoscopic and surgical procedures can also help resolving GERD after RYGB. Conclusions: Although the majority of patients with GERD after RYGB can be effectively managed with medical therapy, some may require endoscopic or surgical treatment. Critical technical elements of RYGB should be considered to reduce the risk of postoperative GERD.
Keyphrases
- gastroesophageal reflux disease
- roux en y gastric bypass
- weight loss
- gastric bypass
- obese patients
- bariatric surgery
- end stage renal disease
- newly diagnosed
- ejection fraction
- chronic kidney disease
- healthcare
- metabolic syndrome
- weight gain
- type diabetes
- peritoneal dialysis
- prognostic factors
- minimally invasive
- adipose tissue
- ultrasound guided
- physical activity
- atrial fibrillation
- coronary artery disease
- machine learning
- artificial intelligence
- bone marrow
- risk assessment
- high fat diet induced
- percutaneous coronary intervention
- replacement therapy