Gastric bypass works for GERD and obesity in patients with prior surgery, says Pitt study

PITTSBURGH, Nov. 15 Laparoscopic gastric bypass surgery can effectively control gastroesophageal reflux disease (GERD) symptoms in morbidly obese patients who had previous antireflux surgery, with the additional benefit of weight loss and improvement of co-morbidities, according to a study published in the November issue of the journal Obesity Surgery.

The University of Pittsburgh School of Medicine study found that gastric bypass is feasible and effective in controlling GERD in patients who had previous antireflux surgery and who have subsequently gained significant weight, and in obese patients who have had previous antireflux procedures and continued to have problems with GERD.

This small study involved seven patients who underwent laparoscopic gastric bypass after having antireflux surgery to control GERD. Patients' co-morbid medical conditions included sleep apnea, diabetes mellitus, hypertension, degenerative joint disease, depression, hypercholesterolemia, polycystic ovarian syndrome and lower extremity edema.

"Despite a morbidity rate of 42.8 percent, this study showed that all patients did well with zero mortality and were satisfied with their condition during the follow-up period, suggesting that the long-term outcome of laparoscopic gastric bypass in obese patients who had previous antireflux surgery is promising. There also was a significant improvement of GERD symptoms following the laparoscopic gastric bypass, which was maintained during follow-up," said Ioannis Raftopoulos, M.D., Ph.D., assistant professor of surgery in the division of thoracic & foregut surgery at the University of Pittsburgh School of Medicine, and principal author of the study. In addition, 70 percent of associated co-morbid medical conditions were either resolved or improved significantly.

GERD is a significant public health problem affecting up to 40 percent of the American adult population.

"Although a direct cause-effect relationship


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