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Gastroesophageal reflux disease (GERD) in obesity
Gastroesophageal reflux disease (GERD) in obesity
Gastroesophageal reflux disease (GERD) - is the development of inflammation in the lower third of the esophagus due to insufficiently tight closure of circular muscle (sphincter) located between the esophagus and stomach. Many large epidemiological studies have found that symptoms of GERD and in lean individuals and obese patients, are practically identical.
However, it is not clear whether obesity causes the development of reflux (stomach acid cast into the esophagus), or simply frequently associated with GERD. Due to the presence of conflicting data, it is unknown whether there is a relationship between obesity and known factors predisposing to the development of GERD (atony of the lower esophageal sphincter and the change in pH in the acid side in nizhey esophagus). So no less, many studies confirm the influence of obesity on the appearance of symptoms of reflux. Although the increase in abdominal pressure caused by the increased size of the stomach, people suffering from obesity may predispose to the emergence of reflux, it is unknown whether there any controlled randomized (statistically significant) studies to assess the effect of weight reduction to reduce the symptoms of reflux.
The fact that even moderate weight loss leads to significant improvements in patients, says the most likely for the fact that clinical benefit is achieved thanks to a diet more than the actual weight loss. Studies of obese patients with first-degree and symptoms of GERD have shown that weight reduction has not led to improvement or change in rates of esophageal pH with 24-hour supervision.
Characteristically, the symptoms of GERD always disappear immediately after surgery for obesity, even before significantly reduced body weight. This suggests that the deletion of the acidic contents of the cast or bile into the esophagus, but not losing weight, improves the condition of patients. Severe gastro-oesophageal reflux may occur after vertical gastroplasty. Although other studies have shown that vertical gastroplasty shrouded and gastric banding, in which increased resistance to the passage of food through the constriction formed (see surgical treatment) does not change the tone of the lower esophageal sphincter and increases the number of reflux episodes.
