Wake Forest Baptist Health Winston-Salem, NC, United States
Judy Ugwuegbu, BS1, Steven Delaney, MD2, Troy M. Pleasant, MD1, Steven Clayton, MD1 1Wake Forest Baptist Health, Winston-Salem, NC; 2Wake Forest Baptist Medical Center, Winston-Salem, NC
Introduction: Up to one-quarter of the US population suffers from gastroesophageal reflux disease (GERD). As rates of obesity increase, so do concerns about GERD and the negative sequelae associated with it. Surgical operations for weight loss carry multiple benefits for patients that extend beyond sustained reduction in BMI to include improvement of metabolic syndrome, lowering risk for some cancers, increasing survival, and increasing quality of life. Bariatric surgery has been shown to decrease GERD symptoms in some patients, however for others it has resulted in worsening or even de novo GERD. We aimed to study the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on GERD.
Methods: We conducted an IRB approved retrospective chart review at a tertiary medical center examining 100 patients who underwent bariatric weight loss surgery to analyze anti-reflux medication use (PPI and H2) as a surrogate for GERD. We reviewed progress notes 2 years preceding and 2 years following the surgical procedure. We collected data on demographics, weight loss, and medication use/type/dose/frequency before and after surgery.
Results: 100 patients underwent SG (N=50) or RYGB (N=50). Average age, gender, race, and BMI prior to surgery did not significantly differ between the groups. Consistent with other observational studies, patients who underwent RYGB tended to lose more weight than SG in the form of average change in BMI (15.5 vs. 11.5, p< 0.004). 74% of RYGB patients were on anti-reflux medication prior to surgery while 62% of SG patients were on medication prior to surgery (p=0.20). Prior to surgery PPI’s were the primary medication for both groups (60% in RYGB and 58% in SG patients). Following surgery, 56% of RYGB patients and 76% of SG patients were prescribed anti-reflux medication (p< 0.04).
Discussion: We found an 18% absolute reduction in PPI and H2 medication use for patients who underwent RYGB. In contrast, SG patients showed a 14% absolute increase in medication use. This is consistent with the thought that RYGB may be more appropriate for patients diagnosed with GERD. Using PPI and H2 medications as a surrogate for GERD symptoms/severity has limitations and may not be as equitable as objective testing for GERD. Objective reflux testing prior to and after surgery may offer an option for future studies.
Disclosures: Judy Ugwuegbu indicated no relevant financial relationships. Steven Delaney indicated no relevant financial relationships. Troy Pleasant indicated no relevant financial relationships. Steven Clayton indicated no relevant financial relationships.
Judy Ugwuegbu, BS1, Steven Delaney, MD2, Troy M. Pleasant, MD1, Steven Clayton, MD1. P1947 - Comparison and Outcomes of Bariatric Surgery Effects on GERD, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
