Pathophysiological Mechanisms of GASTRO-ESOPHAGEAL Reflux Following Sleeve Gastrectomy.

Abstract

OBJECTIVE: to evaluate the mechanisms associated with reflux events following sleeve gastrectomy (SG). SUMMARY BACKGROUND DATA: Gastro-esophageal reflux (GERD) post-SG is a critical issue due to symptom severity, impact on quality of life, requirement for re-operation, and potential for Barrett's esophagus. The pathophysiology is incompletely delineated. METHODS: Post-SG patients, stratified into asymptomatic and symptomatic, underwent protocolized nuclear scintigraphy (n=83), 24-hour esophageal pH monitoring, and stationary manometry (n=143) to characterize reflux patterns. Ten patients underwent fasting and post-prandial concurrent manometry and pH for detailed analysis of reflux events. R..