Prevalence of gastroesophageal reflux and risk factors for erosive esophagitis in obese patients considered for bariatric surgery
| Autor: | Halim Bou Daher, Amr Al-Abbas, Ala I. Sharara, Hanaa Dakour Aridi, Ramzi S. Alami, Yasser H. Shaib, Luma Basma O. Rustom, Mohamad A. Minhem, Yervant Ichkhanian, Bassem Y. Safadi, Hussein H. Rimmani, Rani H. Shayto |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy medicine.medical_treatment Population Gastric Bypass Logistic regression Sensitivity and Specificity Hiatal hernia 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Prevalence medicine Humans Endoscopy Digestive System Obesity Prospective Studies Lebanon education Prospective cohort study Esophagitis Peptic education.field_of_study Hepatology medicine.diagnostic_test business.industry Esophagogastroduodenoscopy Gastroenterology Reflux Proton Pump Inhibitors Middle Aged medicine.disease Surgery Cross-Sectional Studies Hernia Hiatal Logistic Models 030220 oncology & carcinogenesis Multivariate Analysis Gastroesophageal Reflux GERD Female 030211 gastroenterology & hepatology business |
| Zdroj: | Digestive and Liver Disease. 51:1375-1379 |
| ISSN: | 1590-8658 |
| Popis: | Background Gastroesophageal reflux disease (GERD) is common in obese individuals. Prospective studies investigating validated GERD questionnaires and clinical parameters at identifying erosive esophagitis (EE) in this population are limited. Objective To prospectively evaluate the prevalence of GERD in obese patients considered for bariatric surgery and identify risk and predictive factors for EE. Methods Eligible patients completed two validated questionnaires: GERDQ and Nocturnal Symptom Severity Impact (N-GSSIQ) before routine esophagogastroduodenoscopy. Results 242 consecutive patients were enrolled (130 females; mean age 37.8 ± 11.8 years; mean BMI 40.4 ± 5.3 kg/m2). The overall prevalence of gastroesophageal reflux (GERDQ ≥ 8, EE and/or PPI use) was 62.4%. EE was identified in 82 patients (33.9%) including 13/62 (21.0%) receiving PPIs at baseline. Multivariate logistic regression identified GERDQ ≥ 8 (OR = 6.3, 95%CI 3.0–13.1), hiatal hernia (OR = 4.2, 95%CI 1.6–10.7), abnormal Hill grade (OR = 2.7, 95%CI 1.4–5.4), and tobacco use (OR = 2.5, 95%CI 1.2–4.9) as independent risk factors for EE. A pre-endoscopic composite assessment including GERDQ ≥ 8 and presence of severe nocturnal reflux symptoms had 90% specificity and 20.7% sensitivity in identifying EE (NPV 68.9% and PPV 51.5%). Conclusion GERD is highly prevalent in obese patients. Anthropometric data and GERD questionnaires have limited accuracy at predicting erosive disease. Pre-operative endoscopic assessment in this population appears warranted. |
| Databáze: | OpenAIRE |
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