• cancer
• immune cell
• inflammation
• microenvironment
• obesity
• sleeve gastrectomy

• Bariatric surgery
• Gastritis
• Helicobacter pylori

• Male
• Humans
• Female
• Adult
• Middle Aged
• Helicobacter Infections/complications
• Helicobacter pylori
• Obesity, Morbid/surgery
• Retrospective Studies
• Prevalence
• Bariatric Surgery/adverse effects
• Gastritis/complications

• Chronic gastritis with erosion
• Endoscopy
• Multi-center, randomized study
• Traditional Chinese medicine

• Bariatric surgery
• Bioabsorbable mesh
• Hiatal hernia
• Recurrence rate

• EGFR
• Gastrointestine
• High-fat diet
• LepR
• Neoplasia
• TFF3

• Guangxi Zhuang Autonomous Region Health and Health Commission Self-Financed Research Projects

• Bariatric Surgery
• Esophago-Gastro-Duodenal Endoscopy
• IFSO Position Statement
• Systematic Review

• Acute hiatal hernia
• Bariatric surgery
• Emergency surgery
• Fundoplasty
• Hiatal hernia
• Incarceration
• Laparoscopic sleeve gastrectomy
• Laparoscopy
• Minimally invasive surgery
• Perioperative care
• Postoperative complications
• Technique
• Vertical sleeve gastrectomy

• BMI
• Helicobacter pylori; eradication
• chromoendoscopy
• gastric atrophy
• verrucous gastritis

Gastroesophageal reflux disease (GERD) and obesity have become serious problems affecting global health. The surgical treatment strategy for GERD patients with obesity is still a difficult point. In particular, obesity exacerbates the occurrence of GERD, and simple anti-reflux surgery has limited efficacy in obese patients. Currently, bariatric surgery is a good choice for the treatment of such patients, and Roux-en-Y gastric bypass is the best choice. Revisional surgery remains to be standardized for serious complications in postoperative patients. In addition, the new anti-reflux bariatric surgery that has been emerging in recent years is expected to be an effective alternative treatment for GERD patients with obesity.

• Gastroesophageal reflux disease
• Obesity
• Bariatric and metabolic surgery
• Anti-reflux surgery

Obesity is a global health epidemic with considerable economic burden. Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk. Sleeve gastrectomy accounts for almost half of all bariatric surgeries worldwide but concerns regarding its relationship with gastroesophageal reflux disease (GERD) has been a topic of debate. GERD, including erosive esophagitis, is highly prevalent in the obese population. The role of pre-operative endoscopy in bariatric surgery has been controversial. Two schools of thought exist on the matter, one that believes routine upper endoscopy before bariatric surgery is not warranted in the absence of symptoms and another that believes that symptoms are poor predictors of underlying esophageal pathology. This debate is particularly important considering the evidence for the association of laparoscopic sleeve gastrectomy (LSG) with de novo and/or worsening GERD compared to the less popular Roux-en-Y gastric bypass procedure. In this paper, we try to address 3 burning questions regarding the inter-relationship of obesity, GERD, and LSG: (1) What is the prevalence of GERD and erosive esophagitis in obese patients considered for bariatric surgery? (2) Is it necessary to perform an upper endoscopy in obese patients considered for bariatric surgery? And (3) What are the long-term effects of sleeve gastrectomy on GERD and should LSG be done in patients with pre-existing GERD?

• Reflux
• Erosive
• Acid
• Bariatric
• Obesity
• Gastric bypass
• Endoscopy

• Endoscopy, Gastrointestinal
• Esophagitis/epidemiology
• Esophagitis/etiology
• Gastric Bypass/adverse effects
• Gastric Bypass/methods
• Gastroesophageal Reflux/diagnosis
• Gastroesophageal Reflux/epidemiology
• Gastroesophageal Reflux/etiology
• Gastroplasty/adverse effects
• Gastroplasty/methods
• Humans
• Laparoscopy/adverse effects
• Laparoscopy/methods
• Obesity, Morbid/surgery
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Preoperative Period
• Prevalence
• Time Factors

• high-fat
• leptin
• microbiota
• protumorigenesis
• stomach

• Animals
• Carcinogenesis/drug effects
• Diet, High-Fat/adverse effects
• Dietary Fats/adverse effects
• Disease Models, Animal
• Gastric Mucosa/drug effects
• Leptin/metabolism
• Metaplasia
• Mice
• Obesity/etiology
• Receptors, Leptin/metabolism
• STAT3 Transcription Factor/metabolism
• Signal Transduction/drug effects
• Stomach/pathology
• beta Catenin/metabolism

• Dysbiosis
• Gastric leptin
• Gastric microbiota
• High-fat diet
• Intestinal metaplasia
• Obesity

• Bowel obstruction
• Case report
• Intussusception
• Laparoscopic one anastomosis gastric bypass

• H. pylori
• cardiovascular risk factors
• Andkhoy
• Afghanistan

• Afghanistan/epidemiology
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cross-Sectional Studies
• Female
• Follow-Up Studies
• Helicobacter Infections/complications
• Helicobacter pylori/isolation & purification
• Humans
• Male
• Middle Aged
• Prognosis
• Risk Factors

To explore the association between Helicobacter pylori (H. pylori) infection and obesity/weight gain in a Chinese population.

Our primary outcome was the change in body mass index (BMI). The generalized linear models were used to explore the association between H. pylori infection and the change of BMI, and the logistic regression models were used to explore the association between H. pylori infection and obesity.

A total of 3039 subjects were recruited and analyzed, of which 12.8% were obese. The prevalence of H. pylori infection was 53.9% (1639/3039) overall and 54.6% (212/388) in the obese subjects. The change of BMI in the H. pylori (+) group was not significantly higher than that in the H. pylori (-) group after adjustment for potential confounding factors [RR = 0.988, 95%CI: 0.924-1.057, P = 0.729]. The prevalence of obesity decreased 1.1% in the H. pylori (+) group and 0.5% in the H. pylori (-) group. The RR of H. pylori infection for obesity was 0.831 (95%CI: 0.577-1.197, P = 0.321) after the adjustment.

H. pylori infection was not associated with overweight/obesity observed from the retrospective study in this Chinese population.

• Obesity
• Helicobacter pylori
• Retrospective study
• China

• Adult
• Body Mass Index
• Female
• Helicobacter Infections/complications
• Helicobacter pylori/isolation & purification
• Humans
• Male
• Middle Aged
• Obesity/microbiology
• Retrospective Studies

• Functional gastrointestinal disorders
• Morbid obesity
• Obesity
• Rome criteria

Obesity increases the risk for malignancies in various tissues including the stomach. Atrophic gastritis with precancerous lesions is an obesity-associated disease; however, the mechanisms that underlie the development of obesity-associated atrophic gastritis are unknown. Leptin is a hormone derived from stomach as well as adipose tissue and gastric leptin is involved in the development of gastric cancer. The aim of the current study is to investigate the involvement of leptin receptor signaling in the development of atrophic gastritis during diet-induced obesity.

Male C57BL/6, ob/ob and db/db mice were fed a high-fat diet (HFD) or a control diet (CD) from 1 week to 5 months. Pathological changes of the gastric mucosa and the expression of molecules associated with atrophic gastritis were evaluated in these mice.

HFD feeding induced gastric mucosal hyperplasia with increased gastric leptin expression. Mucosal hyperplasia was accompanied by a higher frequency of Ki67-positive proliferating cells and atrophy of the gastric glands in the presence of inflammation, which increased following HFD feeding. Activation of ObR signaling-associated molecules such as ObR, STAT3, Akt, and ERK was detected in the gastric mucosa of mice fed the HFD for 1 week. The morphological alterations associated with gastric mucosal atrophy and the expression of Muc2 and Cdx2 resemble those associated with human intestinal metaplasia. In contrast to wild-type mice, leptin-deficient ob/ob mice and leptin receptor-mutated db/db mice did not show increased Cdx2 expression in response to HFD feeding.

Together, these results suggest that activation of the leptin signaling pathway in the stomach is required to develop obesity-associated atrophic gastritis.

The online version of this article (doi:10.1186/s12986-016-0066-1) contains supplementary material, which is available to authorized users.

• Atrophic gastritis
• High-fat diet
• Leptin
• Obesity

• Anemia
• Bariatric surgery
• Cirugía bariátrica
• Déficit de hierro
• Iron deficiency
• Iron therapy
• Tratamiento con hierro

Weight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between weight change (loss or gain) and specific GI symptoms remains poorly described. We assess the associations between GI symptoms and weight change in a population-based sample of Australian adults.

The prevalence of 26 GI symptoms was determined by a postal survey to 5000 residents in western Sydney, Australia (60% response rate). These were classified a priori into 5 symptom groups–abdominal pain, esophageal symptoms, dysmotility symptoms, diarrhea and constipation. Weight change was measured by two items which assessed weight loss and weight gain. Clinically relevant weight change was defined as a loss or gain of 3 or more kilograms in the past 3 months.

Prevalence estimates for clinically relevant weight loss and gain in the past 3 months were 10.3% and 8.1%, respectively. When the 5 symptom groups were evaluated simultaneously, the dysmotility symptoms of fullness after meals emerged as a predictor of both weight loss (OR, 1.57; 95% CI, 1.32–1.88; P < 0.001) and weight gain (OR, 0.85; 95% CI, 0.72–0.99; P = 0.040), which also included bloating (OR, 1.64; 95% CI 1.46–1.84; P < 0.001). The associations remained significant following adjustment for socio-economic status, body mass index, and eating behaviors.

Specific dysmotility symptoms are independently predictive of both weight loss and weight gain. Different pathogenic mechanisms may be involved.

• Body mass index
• Gastrointestinal diseases
• Prevalence
• Weight gain
• Weight loss

• PCOS
• cardiometabolic risk-factors
• fructose
• low calorie diets
• obesity
• weight loss

• Bariatric surgery
• Cirugía bariátrica
• Gastroscopia
• Gastroscopy
• Obesidad
• Obesity

•

Since early postoperative nausea and vomiting are fairly common, a high index of suspicion was essential for the diagnosis.

Laparoscopic sleeve gastrectomy has been accepted as a standalone effective bariatric procedure. With the increase in the number of cases done worldwide, we are witnessing the emergence of new unexpected complications.

A seemingly straight forward sleeve gastrectomy was complicated by acute post-operative vomiting which was diagnosed as an acute intra thoracic migration of part of the new sleeve. Surgical repair was done, with reduction and fixation of the stomach. Patient was subsequently relieved of his symptoms and discharged.

This is a rare complication of a relatively well studied operation. Faced with severe post operative repeated vomiting, clinical suspicion and correct use of all para-clinical tools should help delineate the cause.

We report this case hoping to expand the existing literature on the topic and to highlight the potential role of gastrophrenic membrane dissection in the occurrence of such complication.

• Fixation of the sleeve
• Gastrophrenic membrane
• Intrathoracic migration
• Sleeve gastrectomy

Background: Several reports have shown an increased prevalence of gastrointestinal (GI) symptoms in obese subjects in community-based studies. To better understand the role of the GI tract in obesity, and because there are limited clinic-based studies, we documented the prevalence of upper and lower GI symptoms in morbidly obese individuals in a clinic setting.

Objective: The aim of our study was to compare the prevalence of GI symptoms in morbidly obese individuals in a weight management clinic with non-obese individuals with similar comorbidities as morbidly obese individuals in an Internal Medicine clinic.

Methods: Class II and III obese patients BMI >35 kg/m² (N = 114) and 182 non-obese patients (BMI <25 kg/m²) completed the GI symptoms survey between August 2011 and April 2012 were included in this study. The survey included 24 items pertaining to upper and lower GI symptoms. The participants rated the frequency of symptoms as absent (never, rarely) or present (occasionally, frequently). The symptoms were clustered into five categories: oral symptoms, dysphagia, gastroesophageal reflux, abdominal pain, and bowel habits. Responses to each symptom cluster were compared between obese group and normal weight groups using logistic regression.

Results: Of the 24 items, 18 had a higher frequency in the obese group (p < 0.005 for each). After adjusting for age and gender, the obese patients were more likely to have upper GI symptoms: any oral symptom (OR = 2.3, p = 0.0013), dysphagia (OR 2.9, p = 0.0006), and any gastroesophageal reflux (OR 3.8, p < 0.0001). Similarly, the obese patients were more likely to have lower GI symptoms: any abdominal pain (OR = 1.7, p = 0.042) and altered bowel habits (OR = 2.8, p < 0.0001).

Conclusion: These observations suggest a statistically significant increase in frequency of both upper and lower GI symptoms in morbidly obese patients when compared to non-obese subjects.

• body mass index
• clinic-based studies
• gastrointestinal
• obesity
• symptoms

• Bariatric surgery
• Gastric bypass
• Gastroscopy
• Metabolic syndrome
• Morbid obesity

• Adult
• China/epidemiology
• Diagnosis, Differential
• Female
• Gastric Bypass/methods
• Gastrointestinal Diseases/complications
• Gastrointestinal Diseases/diagnosis
• Gastrointestinal Diseases/epidemiology
• Gastroscopy/methods
• Humans
• Incidence
• Laparoscopy/methods
• Male
• Middle Aged
• Obesity, Morbid/epidemiology
• Obesity, Morbid/surgery
• Preoperative Period
• Retrospective Studies
• Treatment Outcome

The present review summarizes the prevalence and active clinical problems in obese patients with Helicobacter pylori (H. pylori) infection, as well as the outcomes after bariatric surgery in this patient population. The involvement of H. pylori in the pathophysiology of obesity is still debated. It may be that the infection is protective against obesity, because of the gastritis-induced decrease in production and secretion of the orexigenic hormone ghrelin. However, recent epidemiological studies have failed to show an association between H. pylori infection and reduced body mass index. H. pylori infection might represent a limiting factor in the access to bariatric bypass surgery, even if high-quality evidence indicating the advantages of preoperative H. pylori screening and eradication is lacking. The clinical management of infection is complicated by the lower eradication rates with standard therapeutic regimens reported in obese patients than in the normal-weight population. Prospective clinical studies to ameliorate both H. pylori eradication rates and control the clinical outcomes of H. pylori infection after different bariatric procedures are warranted.

• Helicobacter pylori
• Obesity
• Bariatric surgery
• Ghrelin
• Antibiotic resistance

• Bariatric Surgery/adverse effects
• Body Mass Index
• Helicobacter Infections/diagnosis
• Helicobacter Infections/drug therapy
• Helicobacter Infections/epidemiology
• Helicobacter Infections/microbiology
• Helicobacter pylori/pathogenicity
• Humans
• Obesity/diagnosis
• Obesity/epidemiology
• Obesity/physiopathology
• Obesity/surgery
• Prevalence
• Risk Factors
• Treatment Outcome

• adiponectin
• hypoadiponectinemia
• obesity-related diseases
• visceral fat

• Adiponectin/blood
• Adiponectin/deficiency
• Biomarkers/blood
• Diabetes Mellitus, Type 2/physiopathology
• Dyslipidemias/complications
• Dyslipidemias/physiopathology
• Female
• Humans
• Insulin Resistance/physiology
• Intra-Abdominal Fat/metabolism
• Life Style
• Male
• Metabolism, Inborn Errors/blood
• Obesity/complications
• Protein Multimerization
• Sleep Apnea Syndromes/complications
• Sleep Apnea Syndromes/physiopathology

• Laparoscopic sleeve gastrectomy
• Roux-en-Y gastric bypass
• adjustable gastric band
• bariatric surgery
• hiatal hernia
• hiatal hernia repair
• obesity
• paraesophageal hernia
• paraesophageal hernia repair

• Bariatric surgery
• Gastroesophageal reflux
• Hiatal hernia
• Morbid obesity

AIM: To analyze the relationship between body mass index (BMI), hiatal hernia (HH) and gastroesophageal reflux (including symptoms and esophagitis) in patients with gastroesophageal reflux disease (GERD).

METHODS: Five hundred and ninety patients diagnosed with GERD at our hospital from June 2008 to Oct 2011 were included in the study. Gastroesophageal reflux symptoms were assessed using the Reflux Disease Questionnaire (RDQ). Erosive esophagitis (EE), non-erosive reflux disease (NERD), and hiatal hernia (HH) were diagnosed by gastroscopy. Patients were categorized into four groups according to BMI: underweight (BMI < 18.5 kg/m²), normal weight (18.5-22.9 kg/m²), overweight (23.0-24.9 kg/m²), and obesity (≥ 25 kg/m²). The clinical characteristics of GERD, relationship between HH and BMI, between BMI/HH and symptoms, and between BMI/HH and EE were analyzed.

RESULTS: RDQ score was 13.33 ± 5.66. EE accounted for 52.2% (308/590). BMI was (23.64±3.10) kg/m². The percentages of underweight, normal, overweight and obese patients were 3.7% (22/590), 37.0% (218/590), 23.7% (140/590) and 35.6% (210/590), respectively. The incidences of HH were 0, 6.0% (13/218), 12.9% (18/140), and 16.7% (35/210) in underweight, normal, overweight and obese patients, respectively, with a significant difference among these patients (P = 0.001). RDQ scores of underweight, normal, overweight, and obese patients were 11.95 ± 5.86, 13.33 ± 5.50, 13.45 ± 5.22 and 13.40 ± 6.07, respectively (F = 0.465, P = 0.707). RDQ scores were significantly higher in the HH group (17.36 ± 6.66) than in the non-HH group (17.36 ± 6.66 vs 12.83 ± 5.31, P = 0.005, and multivariate analysis showed a significant difference (P = 0.000). The percentage of overweight and obese patients in the EE group was significantly higher than that in the NERD group (P = 0.000). The number of HH patients who suffered from EE was more than that of patients without HH (P = 0.000). Multivariate analysis showed that BMI and HH were important risk factors for EE.

CONCLUSION: HH may be an important mechanism responsible for EE in obese patients. HH has a more important significant association with GERD symptoms than BMI. BMI and HH are risk factors for EE.

• Gastroesophageal reflux disease
• Body mass index
• Hiatal hernia