Sleeve Gastrectomy Confers Higher Risk of Gastroesophageal Reflux Disease Than Gastric Bypass: A Randomized Controlled Trial from the Oseberg Reflux Working Group

Obesity is associated with increased intra-abdominal pressure, impaired gastric emptying, and decreased lower esophageal sphincter (LES) pressure, all factors predisposing for gastroesophageal reflux disease (GERD). 1 Hampel H. et al. Ann Intern Med. 2005; 143: 199-211 Crossref PubMed Scopus (875) Google Scholar Furthermore, autonomic neuropathy in diabetes may increase the risk of GERD because of abnormal peristalsis and reduced LES pressure. Accordingly, patients with obesity and/or type 2 diabetes have a high prevalence of GERD and esophageal motility disorders. Weight loss reduces acid reflux. In addition, Roux-en-Y gastric bypass (RYGB) is considered an effective antireflux procedure, whereas sleeve gastrectomy (SG) may induce or worsen GERD. 2 Gu L. et al. Obes Surg. 2019; 29: 4105-4113 Crossref PubMed Scopus (48) Google Scholar Previous studies assessing GERD after SG were limited by unclear definitions of GERD, and it is unclear whether SG and RYGB affect GERD differently. 2 Gu L. et al. Obes Surg. 2019; 29: 4105-4113 Crossref PubMed Scopus (48) Google Scholar Therefore, we aimed to compare the 1-year effects of SG and RYGB on prespecified secondary GERD outcomes from the randomized controlled Oseberg trial (Supplementary Methods), 3 Borgeraas H. et al. BMJ Open. 2019; 9e024573 Crossref PubMed Scopus (4) Google Scholar hypothesizing that those who underwent SG would have a higher 1-year risk of subjective and objective measures of GERD.