Among bariatric procedures,
** gastric sleeve ** and
vertical banded gastroplasty were shown to worsen reflux symptoms
** Gastric banding ** is associated with reflux symptoms in a considerable proportion of patients.
Curr Gastroenterol Rep. 2011 Jun;13(3):205-12.
Obesity and GERD: Pathophysiology and Effect of Bariatric Surgery.
Division of Gastroenterology, University Clinics of Visceral Surgery and Medicine, Bern University Hospital, Inselspital Bern, Bern, Switzerland, email@example.com.
Epidemiologic, endoscopic, and pathophysiologic studies document the relationship between obesity and gastroesophageal reflux disease (GERD). Increased body mass index and accumulation of visceral fat are associated with a two- to threefold increased risk of developing reflux symptoms and esophageal lesions. Given this association, many studies were designed to evaluate the outcome of reflux symptoms following conventional and surgical treatment of obesity. Among bariatric procedures, gastric sleeve and banded gastroplasty were shown to have no effect or even worsen reflux symptoms in the postoperative setting. Gastric banding improves reflux symptoms and findings (endoscopic and pH-measured distal esophageal acid exposure) in many patients, but is associated with de novo reflux symptoms or lesions in a considerable proportion of patients. To date, Roux-en-Y gastric bypass is the most effective bariatric procedure that consistently leads to weight reduction and improvement of GERD symptoms in patients undergoing direct gastric bypass and among those converted from restrictive bariatric procedures to gastric bypass.