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Inicio Endoscopia Trastornos motores y endoscópicos en sujetos obesos asintomáticos
Información de la revista
Vol. 26. Núm. 1.
Páginas 6-11 (enero - marzo 2014)
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Vol. 26. Núm. 1.
Páginas 6-11 (enero - marzo 2014)
ARTÍCULO ORIGINAL
Open Access
Trastornos motores y endoscópicos en sujetos obesos asintomáticos
Motor and endoscopic disorders in asymptomatic obese subjects
Visitas
2893
C.D. Quiróz-Guadarramaa,
Autor para correspondencia
radheyadqg@hotmail.com

Autor para correspondencia. Servicio de Endoscopia Gastrointestinal, Hospital General “Dr. Manuel Gea González”. Calzada de Tlalpan N° 4800, Colonia Sección XVI, C.P. 14080, México D.F., México. Tel.: +(0155) 4000 3000; ext. 3059.
, M.E. Rojano-Rodríguezb, J.J. Herrera-Esquivelc, O.A. Lárragac, L.S. Romero-Loerad, E. Cárdenas-Lailsonc, R. Dionisioc, I. del Río-Suárezc, J.M. Morales-Vargasa, M. Muciob
a Departamento de Endoscopia Gastrointestinal, Hospital General “Dr. Manuel Gea González”, México D.F., México
b Clínica de Obesidad, Hospital General “Dr. Manuel Gea González”, México D.F., México
c Motilidad Gastrointestinal, Hospital General “Dr. Manuel Gea González”, México D.F., México
d Cirugía Endoscópica, Hospital General “Dr. Manuel Gea González”, México D.F., México
Este artículo ha recibido

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Información del artículo
Resumen
Introducción

La obesidad es un factor de riesgo para el desarrollo de enfermedad por reflujo gastroesofágico. El objetivo de este estudio fue comparar los hallazgos endoscópicos y manométricos entre pacientes con obesidad y sujetos no obesos asintomáticos.

Material y métodos

Se realizó un estudio prospectivo, comparativo con 56 pacientes con obesidad, sin síntomas de reflujo, con índice de DeMeester < 14.7, los cuales fueron comparados con 30 sujetos voluntarios no obesos asintomáticos.

Resultados

la presencia de hernia hiatal y esofagitis fue más frecuente en el grupo de pacientes con obesidad (hernia hiatal GI 28%, GII 10%; p<0.05) (esofagitis GI 8.9%, GII 0%). La presión del esfínter esofágico inferior fue menor en los sujetos obesos (GI 7.18 ± 3.78, GII 12.84 ± 4.82; p<0.05). Se identificó una fuerte asociación entre la obesidad y la dismotilidad del cuerpo esofágico (RM=7; IC 95%=2.73-22.88). En conclusión, los pacientes con obesidad exhiben mayor frecuencia de hernia hiatal y esofagitis, así como disminución de la presión del esfínter esofágico inferior aún cuando son asintomáticos para reflujo. Existe una fuerte asociación entre la dismotilidad del cuerpo esofágico y la obesidad.

Palabras clave:
obesidad
Motilidad esofágica
Enfermedad por reflujo gastroesofágico
Hernia hiatal
Esfínter esofágico inferior
México.
Abstract
Introduction

Obesity is associated with gastroesophageal reflux. The aim of this prospective study was to compare endoscopic and manometric findings in asymptomatic obese patients and compare it to non-obese individuals.

Material and methods

A prospective, comparative study was conducted with 56 obese patients without GERD symptoms and index DeMeester reflux < 14.7 were compared to 30 asymptomatic no-obese individuals.

Results

the presence of hiatal hernia and esophagitis was more frequent in the group of obese patients (hiatal hernia GI 28%, GI GII 10%; p<0.05) (esophagitis GI 8.9%, GII 0%). The lower esophageal sphincter pressure was lower in obese subjects (GI 7.18 ± 3.78, GII 12.84 ± 4.82; p<0.05). We identified a strong association between obesity and esophageal body dysmotility (OR=7; CI 95%=2.73-22.88). In conclusion, obese patients show increased frequency of hiatal hernia and esophagitis, as well as decreased lower esophageal sphincter pressure even when they are asymptomatic for reflux. There is a strong association between esophageal body dysmotility and obesity

Keywords:
obesity
Esophageal motility
Gastroesophageal reflux
Hiatal hernia
lower esophageal sphincter
Mexico.
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Bibliografía
[1]
D. Yach, D. Stuckler, K.D. Brownell.
Epidemiologic and economic consequences of the global epidemics of obesity and diabetes.
Nat Med, 12 (2006), pp. 62-66
[2]
K.M. Flegal, M.D. Carroll, ogden Cl, et al.
Prevalence and trends in obesity among US adults, 1999-2000.
JAMA, 288 (2002), pp. 1723-1727
[3]
C. Sánchez-Castillo, E. Pichardo-ontiveros, rP. lópez.
Epidemiología de la obesidad.
Gac Méd Mex, 140 (2004), pp. 3-20
[4]
Murray l, B. Johnston, A. lane, et al.
relationship between body mass and gastro-oesophageal reflux symptoms: the Bristol Helicobacter Project.
Int J Epidemiol, 32 (2003), pp. 645-650
[5]
F.K. Friedenberg, M. Xanthopoulos, G.D. Foster, et al.
The association between gastroesophageal reflux disease and obesity.
Am J Gastroenterol, 103 (2008), pp. 2111-2122
[6]
H.B. El-Serag, D.Y. Graham, J.A. Satia, et al.
obesity is an independent risk factor for GErD symptoms and erosive esophagitis.
Am J Gastroenterol, 100 (2005), pp. 1243-1250
[7]
C.D. Mercer, S.F. Wren, L.R. DaCosta, et al.
Lower esophageal sphincter pressure and gastroesophageal pressure gradients in excessively obese patients.
J Med, 18 (1987), pp. 135-146
[8]
S.A. Wajed, C.G. Streets, C.G. Bremner, et al.
Elevated body mass disrupts the barrier to gastroesophageal reflux.
Arch Surg, 136 (2001), pp. 1014-1018
[9]
L. Sjo¿stro¿m, K. Narbro.
Swedish Obese Subjects Study, et al Effects of bariatric surgery on mortality in Swedish obese subjects.
N Engl J Med, 357 (2007), pp. 741-752
[10]
R.E. Brolin.
Bariatric surgery and long-term control of morbid obesity.
JAMA, 288 (2002), pp. 2793-2796
[11]
P.F. Crookes.
Physiology of reflux disease: role of the lower esophageal sphincter.
Surg Endosc, 20 (2006), pp. S462-S466
[12]
H.H. Hampel, N.S. Abraham, H.B. El-Serag.
Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications.
Ann Intern Med, 143 (2005), pp. 199-211
[13]
D. Sifrim, Holloway r, J. Silny, et al.
Acid, nonacid, and gas reflux in patients with gastroesophageal reflux disease during ambulatory 24-hour pH-impedance recordings.
Gastroenterology, 120 (2001), pp. 1588-1598
[14]
A.J. Bredenoord, B.L. Weusten, R. Timmer, et al.
Addition of esophageal impedance monitoring to pH monitoring increases the yield of symtom association analysis in patients off PPI therapy.
Am J Gastroenterol, 101 (2006), pp. 453-459
[15]
J.C. lopez-Alvarenga, J.A. Vargas, lopez Hl, et al.
Effect of body weight and esophageal damage on the severity of gastroesophageal reflux syntoms Mexican GERD working group.
Archives of Medical Research, 40 (2009), pp. 576-581
[16]
B.W. Jaffin, P. Knoepflmacher, R. Greenstein.
High prevalence of asymptomatic esophageal motility disorders among morbidly obese patients.
obes Surg, 9 (1999), pp. 390-395
[17]
A.M. Küper, K.M. Kramer, A. Kischniak, et al.
Dysfunction of the lower esophageal sphincter and dismotility of the tubular esophagus in morbidly obese patients.
obes Surg, 19 (2009), pp. 1143-1149
[18]
J.S. Koppman, L. Poggi, S. Szomstein, et al.
Esophageal motility disorders in the morbidly obese population.
Surg Endosc, 21 (2007), pp. 761-764
[19]
M. Suter, G. Dorta, V. Giusti, et al.
Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients.
obes Surg, 14 (2004), pp. 959-966
[20]
P.E. O’Brien, J.B. Dixon, W. Brown, et al.
The laparoscopic adjustable gastric band (lap-Band): a prospective study of mediumterm effects on weight, health and quality of life.
obes Surg, 12 (2002), pp. 652-660
[21]
J.C.Y. Wu, L.M. Mui, C.M.Y. Cheung, et al.
Obesity is associated with increased transient lower esophageal sphincter relaxation.
Gastroenterology, 132 (2007), pp. 883-889
[22]
A. Klaus, I. Gruber, G. Wetscher, et al.
Prevalent esophageal body motility disorders underlie aggravation of GErD symptoms in morbidly obese patients following adjustable gastric banding.
Arch Surg, 141 (2006), pp. 247-251
[23]
M. Suter, G. Dorta, V. Giusti, et al.
Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients.
obes Surg, 14 (2004), pp. 959-966
[24]
M. Merrouche, J.M. Sabaté, P. Jouet, et al.
Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery.
obes Surg, 17 (2007), pp. 894-900
[25]
H.G. Weiss, H. Nehoda, B. Labeck, et al.
Treatment of morbid obesity with laparoscopic adjustable gastric banding affects esophageal motility.
Am J Surg, 180 (2000), pp. 479-482
[26]
A. Klaus, H. Weiss.
Is preoperative manometry in restrictive bariatric procedures necessary?.
obes Surg, 18 (2008), pp. 1039-1042
Copyright © 2014. Asociación Mexicana de Endoscopia Gastrointestinal
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