Usefulness of Upper Gastrointestinal Symptoms as a Driver to Prescribe Gastroscopy in Obese Patients Candidate to Bariatric Surgery. A Prospective Study

Obesity Surgery
Marilia CarabottiGianfranco Silecchia

Abstract

Before bariatric surgery, the necessity of routine upper gastrointestinal endoscopy is controversial, and guidelines recommend endoscopy in symptomatic cases. However, impaired visceral sensation occurring in obese patients may be misleading. The purpose of the study is to evaluate prospectively the prevalence of gastrointestinal symptoms, endoscopic findings, and the relation between symptoms and endoscopic findings in obese patients before surgery. One hundred forty-two consecutive patients candidate to primary bariatric surgery filled out the validated Rome III symptomatic questionnaire and performed endoscopy. With a median age of 41 years and BMI of 44 Kg/m(2), 83% were females. Symptoms were referred by 43% of patients: gastroesophageal reflux disease (GERD) (27.9%) and dyspepsia (24.6%), subdivided in postprandial distress (PDS) (66.7%) and epigastric pain (33.3%) syndromes. Of GERD patients, 19.7% presented concomitantly PDS. Belching was present in 8.2% and nausea and/or vomiting in 1.6% of patients. At endoscopy, one or more lesions were present in 47.1% of the patients: erosive esophagitis (5.6%), hiatal hernia (23.2%), gastroduodenal erosions (6.3%), and peptic ulcers (3.5%). At histology, 24% of patients have Helic...Continue Reading

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Citations

Jan 7, 2018·Obesity Surgery·Ammiel Martínez CanilGianfranco Silecchia
Sep 8, 2020·Annals of the New York Academy of Sciences·Eleni FelinskaBeat Müller-Stich
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Feb 26, 2020·Obesity Surgery·Yusef MoullaArne Dietrich
Aug 15, 2020·Annals of the New York Academy of Sciences·Geraldine J OoiMatthew Read
Jan 1, 2021·Journal of Neurogastroenterology and Motility·Ofer Z Fass, Hiroshi Mashimo
Feb 17, 2021·Digestive Diseases and Sciences·Peerapol WangrattanapraneeMary Ellen Jensen
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Jun 22, 2021·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Tammy L KindelUNKNOWN ASMBS Quality Improvement and Patient Safety Committee

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