BACKGROUND: Morbid obesity is becoming more prevalent in the industrialized world. Few data exist regarding the resting lower esophageal sphincter pressure (LESP) and esophageal motility in relationship to body mass index (BMI). METHODS: During a 3-year period, 111 of 152 morbidly obese patients seeking bariatric surgery completed esophageal manometric testing and questionnaire regarding esophageal symptoms. Manometric parameters included wave amplitude and duration of esophageal contractions, percentage of peristaltic function, and resting LESP. Questionnaire data included age, sex, medications, prior medical conditions, and esophageal symptoms. RESULTS: 88 (79%) of the patients were female; 23 (21%) were male. The mean age was 39.8 years (+/- 9.9), the mean BMI was 50.7 kg/m2 (+/- 9.4). There was a lack of correlation between BMI and LESP (r = 0.04). Abnormal manometric findings were observed in 68/111 (61%) patients: 28 (25%) had only hypotensive lower esophageal sphincter (LESP < 10 mm Hg); 16 (14%) had nutcracker esophagus (amplitude >180 mm Hg), 15 (14%) had nonspecific esophageal motility disorders, 8 (7%) had diffuse esophageal spasm (DES), and 1 (1%) had achalasia. Patients with DES had a significantly higher BMI than those with other motility disorders (P < 0.05). Dysphagia was reported in 7 (6%) patients and chest pain in 1 patient. Heartburn and/or regurgitation (gastroesophageal reflux disease, GERD) was noted in 35 patients (32%), of whom 18 (51%) had a hypotensive resting LES. 40 of 68 patients (59%) with abnormal motility tracings did not report any esophageal symptoms. CONCLUSION: Morbid obesity per se does not imply an abnormality of LESP. In addition, a majority of morbidly obese patients who were considering bariatric surgery had no esophageal symptoms but were found to have abnormal esophageal manometric patterns. These findings add support to the suggestion that morbidly obese patients may have abnormal visceral sensation.
BACKGROUND: Morbid obesity is becoming more prevalent in the industrialized world. Few data exist regarding the resting lower esophageal sphincter pressure (LESP) and esophageal motility in relationship to body mass index (BMI). METHODS: During a 3-year period, 111 of 152 morbidly obesepatients seeking bariatric surgery completed esophageal manometric testing and questionnaire regarding esophageal symptoms. Manometric parameters included wave amplitude and duration of esophageal contractions, percentage of peristaltic function, and resting LESP. Questionnaire data included age, sex, medications, prior medical conditions, and esophageal symptoms. RESULTS: 88 (79%) of the patients were female; 23 (21%) were male. The mean age was 39.8 years (+/- 9.9), the mean BMI was 50.7 kg/m2 (+/- 9.4). There was a lack of correlation between BMI and LESP (r = 0.04). Abnormal manometric findings were observed in 68/111 (61%) patients: 28 (25%) had only hypotensive lower esophageal sphincter (LESP < 10 mm Hg); 16 (14%) had nutcracker esophagus (amplitude >180 mm Hg), 15 (14%) had nonspecific esophageal motility disorders, 8 (7%) had diffuse esophageal spasm (DES), and 1 (1%) had achalasia. Patients with DES had a significantly higher BMI than those with other motility disorders (P < 0.05). Dysphagia was reported in 7 (6%) patients and chest pain in 1 patient. Heartburn and/or regurgitation (gastroesophageal reflux disease, GERD) was noted in 35 patients (32%), of whom 18 (51%) had a hypotensive resting LES. 40 of 68 patients (59%) with abnormal motility tracings did not report any esophageal symptoms. CONCLUSION: Morbid obesity per se does not imply an abnormality of LESP. In addition, a majority of morbidly obesepatients who were considering bariatric surgery had no esophageal symptoms but were found to have abnormal esophageal manometric patterns. These findings add support to the suggestion that morbidly obesepatients may have abnormal visceral sensation.
Authors: Wiebke V Petersen; Tobias Meile; Markus A Küper; Marty Zdichavsky; Alfred Königsrainer; Joachim H Schneider Journal: Obes Surg Date: 2012-03 Impact factor: 4.129
Authors: Martin Fried; Vojtech Hainer; Arnaud Basdevant; Henry Buchwald; Mervyn Deitel; Nicholas Finer; Jan Willem M Greve; Fritz Horber; Elisabeth Mathus-Vliegen; Nicola Scopinaro; Rudolf Steffen; Constantine Tsigos; Rudolf Weiner; Kurt Widhalm Journal: Obes Surg Date: 2007-02 Impact factor: 4.129
Authors: M A Küper; K M Kramer; A Kirschniak; A Kischniak; M Zdichavsky; J H Schneider; D Stüker; T Kratt; A Königsrainer; F A Granderath Journal: Obes Surg Date: 2009-06-10 Impact factor: 4.129