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Transdiaphragmatic Pressure Gradient (TPG) Has a Central Role in the Pathophysiology of Gastroesophageal Reflux Disease (GERD) in the Obese and it Correlates with Abdominal Circumference but Not with Body Mass Index (BMI).
de Mello Del Grande, Leonardo; Herbella, Fernando Augusto Mardiros; Katayama, Rafael Caue; Lima, William Guidini; Patti, Marco G.
Afiliação
  • de Mello Del Grande L; Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil.
  • Herbella FAM; Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil. herbella.dcir@epm.br.
  • Katayama RC; Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil.
  • Lima WG; Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP, 04037-003, Brazil.
  • Patti MG; Department of Medicine and Surgery, University of North Carolina, Chapel Hill, NC, USA.
Obes Surg ; 30(4): 1424-1428, 2020 Apr.
Article em En | MEDLINE | ID: mdl-31858395
INTRODUCTION: Pathophysiology of gastroesophageal reflux disease (GERD) is multifactorial. An increased transdiaphragmatic pressure gradient (TPG) may be a main element for GERD in the obese patient. This study aims to evaluate the role of TPG in the physiopathology of GERD in obese individuals. METHODS: We studied 47 unselected consecutive candidates for bariatric operations (body mass index (BMI) > 35). All patients underwent high-resolution manometry and esophageal pH monitoring. Individuals were grouped as GERD + or GERD - based on DeMeester score. Abdominal pressure (AP) and thoracic pressure (TP), transdiaphragmatic pressure gradient (AP-TP), and lower esophageal sphincter (LES) retention pressure (LES basal pressure-TPG) were determined. Manometric variables were compared with a group of 20 lean healthy individuals (BMI < 25). RESULTS: There were 27 (57%) GERD + patients and 20 (43%) GERD - patients. TPG, waist circumference, LES retention pressure, and AP were higher in GERD + group as compared with GERD - individuals. GERD - group had manometric parameters similar to controls except for AP. GERD + patients had higher AP and TPG and lower LES retention pressure compared with controls. TPG and LES retention pressure correlated with waist circumference and DeMeester score. BMI correlated with AP but not with waist circumference or DeMeester score. CONCLUSION: In the obese, GERD presence and severity were associated to a high TPG due to increase AP that correlates with waist circumference.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Refluxo Gastroesofágico Limite: Humans Idioma: En Revista: Obes Surg Assunto da revista: METABOLISMO Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Refluxo Gastroesofágico Limite: Humans Idioma: En Revista: Obes Surg Assunto da revista: METABOLISMO Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos