This is important to note, as the SG is now the most performed surgery encompassing nearly 60% of all bariatric procedures performed worldwide. In fact, as per the 2020 position statement by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the overall risk of developing de novo BE after bariatric surgery, irrespective of the type of procedure, is 1.9% with the incidence as high as 6% up to 5 years after sleeve gastrectomy (SG). However, there is also an inherent risk of developing reflux including BE after bariatric surgery.
īariatric surgery is the most effective treatment for severe obesity. The mechanism by which obesity leads to an increase in GERD is multi-factorial, including increased intra-abdominal pressure, higher incidence of hiatal hernia, transient lower esophageal sphincter (LES) relaxations and a slowed esophageal acid clearance which all contribute to increasing in reflux. Furthermore, chronic erosive esophagitis has been linked to Barrett’s esophagus (BE), and subsequent esophageal and gastro-esophageal junction (GEJ) cancers. In the obese population, GERD can be found in up to 61% of subjects, and it has been demonstrated that increasing body mass index (BMI) also leads to erosive esophagitis. In the United States, obesity is now affecting over 40% of the population and is projected to reach 50% by 2030. GERD is a very common concern at a population level, affecting 27% of adults. The most common symptoms of GERD include heartburn and acid regurgitation, while atypical symptoms include dysphagia, chronic cough, and asthma. Gastroesophageal reflux disease (GERD) is considered a motility disorder wherein reflux of stomach contents into the esophagus or structures more proximal causes symptoms.
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