ABSTRACT
Optimal management of coexisting morbid obesity and gastroesophageal reflux is not known. Silastic ring vertical gastroplasty is an effective treatment for morbid obesity, and Nissen fundoplication is effective in treating gastroesophageal reflux. We combined these two procedures in an animal model and found protection against gastroesophageal reflux without any deleterious effects on pouch emptying.
ABSTRACT
We describe a patient who underwent horizontal gastroplasty for morbid obesity while exhibiting mild symptoms of gastroesophageal reflux disease. The patient lost 34.4 kg, but reflux symptoms progressed to the point of becoming almost incapacitating, associated with erosive esophagitis. The patient subsequently underwent vertical Roux-en-Y gastric bypass, becoming asymptomatic and demonstrating complete healing of the esophageal erosions. Post-operative esophageal pH monitoring demonstrated continuing pathologic reflux in this patient despite her being asymptomatic.
