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Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension.

Abstract

OBJECTIVE

To investigate the influence of untreated (super)morbid obesity and the effects of massive weight loss and chronic gastric distension on gastro-oesophageal reflux.

PATIENTS AND METHODS

Seventeen young morbidly obese patients (32 years old; body weight 166.5 kg; body mass index 55 kg/m2) underwent 24-h ambulatory oesophageal pH monitoring before weight reduction and 4 months after treatment with energy-restricted diet, physical exercise and intragastric balloon or sham placement in a randomized, double-blind design. To minimize bias, both 24-h pH measurements were performed under similar conditions and dietary intake, and patients were matched for age, sex, body weight and body mass index.

RESULTS

At the start, group median data for the fraction of total time, time upright and time supine with pH less than 4 were within normal limits. After a major median weight loss of 38.8 kg in 4 months these parameters did not change. On an individual basis, five out of 17 patients had pathological acid reflux prior to weight loss. This reversed to normal in three subjects, but remained abnormal in two and became abnormal in one patient. The weight loss (58.4 kg) of those remaining or becoming acid refluxers was significantly different (P < 0.01) from those with normal or normalizing pH measurements (36.9 kg). A 4-month period of gastric distension by a 500 ml balloon did not influence acid reflux parameters.

CONCLUSION

The influence of untreated (super)morbid obesity on acid reflux was less pronounced than expected. There was also no major adverse effect of chronic gastric distension. Only excessive weight loss (i.e. 58 kg) appeared to have an untoward effect on acid reflux.

Authors+Show Affiliations

,

Department of Gastroenterology, University of Amsterdam, The Netherlands.

Source

MeSH

Adult
Body Mass Index
Cross-Over Studies
Double-Blind Method
Esophagogastric Junction
Esophagus
Exercise Therapy
Female
Gastric Balloon
Gastroesophageal Reflux
Humans
Hydrogen-Ion Concentration
Male
Monitoring, Ambulatory
Obesity, Morbid
Time Factors
Weight Loss

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

8853250

Citation

Mathus-Vliegen, L M., and G N. Tytgat. "Twenty-four-hour pH Measurements in Morbid Obesity: Effects of Massive Overweight, Weight Loss and Gastric Distension." European Journal of Gastroenterology & Hepatology, vol. 8, no. 7, 1996, pp. 635-40.
Mathus-Vliegen LM, Tytgat GN. Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. Eur J Gastroenterol Hepatol. 1996;8(7):635-40.
Mathus-Vliegen, L. M., & Tytgat, G. N. (1996). Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. European Journal of Gastroenterology & Hepatology, 8(7), pp. 635-40.
Mathus-Vliegen LM, Tytgat GN. Twenty-four-hour pH Measurements in Morbid Obesity: Effects of Massive Overweight, Weight Loss and Gastric Distension. Eur J Gastroenterol Hepatol. 1996;8(7):635-40. PubMed PMID: 8853250.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Twenty-four-hour pH measurements in morbid obesity: effects of massive overweight, weight loss and gastric distension. AU - Mathus-Vliegen,L M, AU - Tytgat,G N, PY - 1996/7/1/pubmed PY - 1996/7/1/medline PY - 1996/7/1/entrez SP - 635 EP - 40 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 8 IS - 7 N2 - OBJECTIVE: To investigate the influence of untreated (super)morbid obesity and the effects of massive weight loss and chronic gastric distension on gastro-oesophageal reflux. PATIENTS AND METHODS: Seventeen young morbidly obese patients (32 years old; body weight 166.5 kg; body mass index 55 kg/m2) underwent 24-h ambulatory oesophageal pH monitoring before weight reduction and 4 months after treatment with energy-restricted diet, physical exercise and intragastric balloon or sham placement in a randomized, double-blind design. To minimize bias, both 24-h pH measurements were performed under similar conditions and dietary intake, and patients were matched for age, sex, body weight and body mass index. RESULTS: At the start, group median data for the fraction of total time, time upright and time supine with pH less than 4 were within normal limits. After a major median weight loss of 38.8 kg in 4 months these parameters did not change. On an individual basis, five out of 17 patients had pathological acid reflux prior to weight loss. This reversed to normal in three subjects, but remained abnormal in two and became abnormal in one patient. The weight loss (58.4 kg) of those remaining or becoming acid refluxers was significantly different (P < 0.01) from those with normal or normalizing pH measurements (36.9 kg). A 4-month period of gastric distension by a 500 ml balloon did not influence acid reflux parameters. CONCLUSION: The influence of untreated (super)morbid obesity on acid reflux was less pronounced than expected. There was also no major adverse effect of chronic gastric distension. Only excessive weight loss (i.e. 58 kg) appeared to have an untoward effect on acid reflux. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/8853250/Twenty_four_hour_pH_measurements_in_morbid_obesity:_effects_of_massive_overweight_weight_loss_and_gastric_distension_ L2 - http://www.diseaseinfosearch.org/result/9028 DB - PRIME DP - Unbound Medicine ER -