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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2016; 22(4): 1627-1638
Published online Jan 28, 2016. doi: 10.3748/wjg.v22.i4.1627
Impact of obesity treatment on gastroesophageal reflux disease
Abraham Khan, Aram Kim, Cassandra Sanossian, Fritz Francois
Abraham Khan, Fritz Francois, Division of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY 10016, United States
Aram Kim, Department of Medicine, New York University School of Medicine, New York, NY 10016, United States
Cassandra Sanossian, New York University School of Medicine, New York, NY 10016, United States
Author contributions: All authors equally contributed to this paper with literature review, analysis, drafting and editing.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fritz Francois, MD, MSc, Division of Gastroenterology, Department of Medicine, New York University School of Medicine, 530 First Avenue, New York, NY 10016, United States. fritz.francois@nyumc.org
Telephone: +1-212-2633250 Fax: +1-212-2634542
Received: July 28, 2015
Peer-review started: July 30, 2015
First decision: August 31, 2015
Revised: September 14, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: January 28, 2016
Processing time: 175 Days and 21.2 Hours
Abstract

Gastroesophageal reflux disease (GERD) is a frequently encountered disorder. Obesity is an important risk factor for GERD, and there are several pathophysiologic mechanisms linking the two conditions. For obese patients with GERD, much of the treatment effort is focused on weight loss and its consistent benefit to symptoms, while there is a relative lack of evidence regarding outcomes after novel or even standard medical therapy is offered to this population. Physicians are hesitant to recommend operative anti-reflux therapy to obese patients due to the potentially higher risks and decreased efficacy, and these patients instead are often considered for bariatric surgery. Bariatric surgical approaches are broadening, and each technique has emerging evidence regarding its effect on both the risk and outcome of GERD. Furthermore, combined anti-reflux and bariatric options are now being offered to obese patients with GERD. However, currently Roux-en-Y gastric bypass remains the most effective surgical treatment option in this population, due to its consistent benefits in both weight loss and GERD itself. This article aims to review the impact of both conservative and aggressive approaches of obesity treatment on GERD.

Keywords: Obesity; Gastroesophageal reflux disease; Fundoplication; Sleeve gastrectomy; Gastric banding; Gastric bypass

Core tip: Obesity and gastroesophageal reflux disease (GERD) have a well-defined relationship, and both the medical and surgical treatment options for both conditions are advancing. However, there is shortage of literature consolidating the effect of obesity treatment on the outcome of GERD. This article aims to detail the evidence behind both standard and novel obesity treatments on the risk and outcome of GERD.