Screening for Barrett’s oesophagus should be considered in patients who underwent sleeve gastrectomy even in the absence of gastroesophageal reflux disease (GERD) symptoms postoperatively, suggests researchers from the University of Florida. The study has been published in the journal Gastrointestinal Endoscopy.
GERD, is a digestive disorder that affects the lower oesophagal sphincter (LES), the ring of muscle between the oesophagus and stomach. This is a chronic disease that occurs when stomach acid or bile flows into the food pipe and irritates the lining. Acid reflux and heartburn more than twice a week may indicate GERD. Barrett’s oesophagus is most often diagnosed in people with long-term GERD. It usually occurs as a result of repeated exposure to stomach acid often resulting in frequent heartburn and chest pain, although many people will have no symptoms.
Sleeve gastrectomy (SG), also called as vertical sleeve gastrectomy, is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature resulting in a sleeve or tube-like structure.
The research revealed that patients who underwent oesophagogastroduodenoscopy (EGD) after sleeve gastrectomy experienced a high prevalence of Barrett’s oesophagus (BE).
EGD is a procedure during which a small flexible endoscope is introduced through the mouth or, with smaller-calibre endoscopes, through the nose and advanced through the pharynx, oesophagus, stomach, and duodenum.
The study evaluated data of patients who had EGD after SG. The primary outcome was the prevalence of BE in these patients. The final analysis of 10 different studies showed 680 patients who had EGD 6 months to 10 years after SG. The pooled prevalence of BE was 11.6%. On logistic meta-regression analysis, there was no significant association between BE and the prevalence of postoperative GERD although there was a linear relationship between the time of postoperative EGD and the rate of esophagitis. The risk of osophagitis increased by 13% each year after SG.
“There was no correlation with gastroesophageal reflux disease (GERD) symptoms. Most cases were observed after 3 years of follow-up.” pointed out the researchers.
“The elevated risk of BE due to [sleeve gastrectomy] should be discussed with patients at the time of surgical referral,” the researchers wrote. “Patients at increased risk of BE should be given the option to have an alternative procedure.”, they added.