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Incidence rates of both obesity and gastro-esophageal reflux disease (GERD) are increasing, particularly in the Western world.
It has been suggested that GERD symptoms may be improved by weight reduction.
Professor Siersema and colleagues from the Netherlands reviewed the literature on the effect of various weight reducing modalities on manifestations of GERD in obese patients.
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| The most favorable effect is likely to be found after bariatric surgery |
| Alimentary Pharmacology & Therapeutics |
The team performed a literature search using PubMed, EMBASE and the Cochrane Library, combining the words obesity and gastro-esophageal reflux with bariatric surgery, diet, lifestyle intervention and weight loss.
With regard to diet/lifestyle intervention (conservative), 4 of 7 studies reported an improvement of GERD.
For Roux-en-Y gastric bypass, a positive effect on GERD was found in all studies, although this was mainly evaluated by questionnaires.
In contrast, for vertical banded gastroplasty, the research team observed no change or even an increase of GERD.
However, the results for laparoscopic adjustable gastric banding were conflicting.
Professor Siersema's team concludes, "Dietary and lifestyle intervention may improve GERD in obese patients."
"However, the most favorable effect is likely to be found after bariatric surgery, especially after Roux-en-Y gastric bypass."
"Future studies need to elucidate for which GERD patients laparoscopic adjustable gastric banding might have a beneficial effect and how they can be identified preoperatively."
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