Dutta Sudhir K, Arora Manish, Kireet Agrawal, Bashandy Hany, Gandsas Alejandro
Division of Gastroenterology, Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
Dig Dis Sci. 2009 Jun;54(6):1243-6. doi: 10.1007/s10620-008-0485-6. Epub 2008 Oct 31.
To prospectively evaluate the frequency of upper gastrointestinal symptoms and associated disorders in morbidly obese patients with endoscopy and histology prior to their gastric bypass surgery in comparison with age- and sex-matched nonobese control subjects.
All patients who were scheduled to undergo laparoscopic gastric bypass for treatment of morbid obesity (body mass index, BMI > 40 kg/m(2)) during a 1-year period (n = 101) were included in the study. Age- and sex-matched nonobese patients who were seen in the medical clinics during the study period were enrolled as control subjects. The demographic data, total body weight, body mass index, and gastrointestinal symptoms were recorded, and the results of upper endoscopy and histology were tabulated. Endoscopic documentation of hiatal hernia, esophagitis, gastritis, gastric polyps, and peptic ulcer disease was also noted along with the histologic findings of the mucosal biopsies from the upper gastrointestinal tract.
The prevalence of heartburn as a symptom was significantly higher (P < 0.05) in the morbidly obese patients (32.6%) compared with in the control group (18.8%). Endoscopically, the prevalence of hiatal hernia was also significantly higher (P < 0.05) in the morbidly obese group (38.6%) compared with in the control group (13.8%). Similarly the frequency of endoscopically and histologically identified gastritis was significantly higher (P < 0.01) in the morbidly obese patient group. However, the frequency of histologically identified Helicobacter pylori was not statistically different in the two groups.
These observations suggest a significant increase in the frequency of heartburn, hiatal hernia, and histologically identified gastritis in morbidly obese patients.
与年龄和性别匹配的非肥胖对照受试者相比，在内镜检查和组织学检查的基础上，前瞻性评估病态肥胖患者在接受胃旁路手术前上消化道症状及相关疾病的发生频率。
纳入所有计划在1年期间接受腹腔镜胃旁路手术治疗病态肥胖（体重指数，BMI>40kg/m²）的患者（n = 101）。将研究期间在门诊就诊的年龄和性别匹配的非肥胖患者作为对照受试者。记录人口统计学数据、总体重、体重指数和胃肠道症状，并将上消化道内镜检查和组织学检查结果制成表格。还记录了食管裂孔疝、食管炎、胃炎、胃息肉和消化性溃疡疾病的内镜诊断结果以及上消化道黏膜活检的组织学发现。
与对照组（18.8%）相比，病态肥胖患者中烧心症状的发生率显著更高（P<0.05）（32.6%）。在内镜检查中，病态肥胖组食管裂孔疝的发生率（38.6%）也显著高于对照组（13.8%）（P<0.05）。同样，病态肥胖患者组内镜检查和组织学检查确诊的胃炎发生率显著更高（P<0.01）。然而，两组中组织学检查确诊的幽门螺杆菌感染率在统计学上无差异。
这些观察结果表明，病态肥胖患者烧心、食管裂孔疝和组织学检查确诊的胃炎的发生率显著增加。
