Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Aliment Pharmacol Ther. 2009 Dec 1;30(11-12):1091-102. doi: 10.1111/j.1365-2036.2009.04146.x. Epub 2009 Sep 16.
Incidence rates of both obesity and gastro-oesophageal reflux disease (GERD) are increasing, particularly in the Western world. It has been suggested that GERD symptoms may be improved by weight reduction.
To review the literature on the effect of various weight reducing modalities on manifestations of GERD in obese patients.
A literature search was performed using PubMed, EMBASE and the Cochrane Library, combining the words obesity and gastro-oesophageal reflux with bariatric surgery, diet, lifestyle intervention and weight loss.
With regard to diet/lifestyle intervention (conservative), four of seven studies reported an improvement of GERD. For Roux-en-Y gastric bypass, a positive effect on GERD was found in all studies, although this was mainly evaluated by questionnaires. In contrast, for vertical banded gastroplasty, no change or even an increase of GERD was noted, whereas the results for laparoscopic adjustable gastric banding were conflicting.
Dietary and lifestyle intervention may improve GERD in obese patients; however, the most favourable effect is likely to be found after bariatric surgery, especially after Roux-en-Y gastric bypass. Future studies need to elucidate for which GERD patients laparoscopic adjustable gastric banding might have a beneficial effect and how they can be identified preoperatively.
肥胖和胃食管反流病（GERD）的发病率都在上升，尤其是在西方世界。有人认为体重减轻可能会改善 GERD 症状。
综述各种减肥方法对肥胖患者 GERD 表现的影响。
使用 PubMed、EMBASE 和 Cochrane 图书馆进行文献检索，将肥胖和胃食管反流与减重手术、饮食、生活方式干预和体重减轻等词结合起来。
关于饮食/生活方式干预（保守），七项研究中有四项报告 GERD 有所改善。对于 Roux-en-Y 胃旁路术，所有研究都发现对 GERD 有积极影响，尽管这主要是通过问卷调查来评估的。相比之下，对于垂直捆绑胃成形术，GERD 没有变化甚至增加，而腹腔镜可调节胃束带术的结果则存在矛盾。
饮食和生活方式的干预可能会改善肥胖患者的 GERD；然而，最有利的效果可能是在减重手术后发现的，尤其是在 Roux-en-Y 胃旁路术后。未来的研究需要阐明腹腔镜可调节胃束带术对哪些 GERD 患者可能有有益的效果，以及如何在术前识别这些患者。
