Obesity and Esophageal Disorders is a comprehensive review on the impact of obesity on esophageal disorders and how to approach, recognize and treat those disorders. Covering the critical gap in awareness on the impact of obesity on esophageal disorders, this reference presents the newest diagnostic technologies, including high resolution manometry, EndoFLIP, wireless pH monitoring, and mucosal integrity devices. The book shows treatment options like bariatric surgery and endo-bariatrics that decrease the latency period for diagnosis and management of patients. Finally, the understanding of the potential effects of different bariatric surgeries on esophageal motility is explored.
This importance reference serves researchers looking to determine future projects by providing novel pathophysiologic mechanisms about how obesity affects GERD and esophageal motility. It serves clinicians, surgeons and trainees with guidance on diagnostic approaches, management options, and how to recognize/treat post-surgical esophageal complications of patients with obesity.
Author(s): Dhyanesh Patel, Robert Kavitt, Shabnam Sarker, Michael Vaezi
Publisher: Academic Press
Year: 2022
Language: English
Pages: 164
City: London
Cover
Obesity and Esophageal Disorders
Copyright
Preface
List of contributors
Contents
1 Obesity and its impact on gastrointestinal health
Overview
Introduction
Epidemiology
Medical Complications
Obesity and Pharmacokinetics
Economic Burden of Obesity
Esophagogastric Disease
Introduction
Epidemiology
Pathophysiology
Manifestations of Disease
Hepatology
Introduction
Epidemiology
Pathophysiology
Diagnosis
Manifestations of Disease
Obesity and the Gut Microbiome
Functional Gastrointestinal Disorders
Pediatric Population
Esophageal physiology
Conclusion
Disclosure
References
2 Impact of obesity on esophageal physiology in pediatrics
Introduction
Physiologic function of the esophagus
Gastroesophageal reflux disease
Impact of obesity
Treatment of obesity
Complications of obesity-induced gastroesophageal reflux disease
Summary
References
3 Obesity and impact on gastroesophageal reflux disease
Structural and physiological changes associated with obesity that contributes to gastroesophageal reflux disease
Structural changes associated with gastroesophageal reflux disease in obesity
Physiological changes associated with gastroesophageal reflux disease in obesity
Lower esophageal sphincter pressure
Transient lower esophageal sphincter relaxation
Intragastric pressure and gastroesophageal pressure gradient
Esophageal motility
Does obesity phenotype matter to gastroesophageal reflux disease/dyspepsia and role of genomic testing?
Impact of body fat distribution in gastroesophageal reflux disease
Genes associated with obesity and gastroesophageal reflux disease
Diagnostic modalities, pathophysiology, and management options
Endoscopic techniques
Reflux monitoring
Other diagnostic techniques
Gastroesophageal reflux disease treatment
Challenges in the treatment of gastroesophageal reflux disease in obesity
References
4 Impact of obesity on Barrett’s esophagus and esophageal adenocarcinoma
Introduction
Mechanisms of carcinogenesis
Local inflammation from acid and bile reflux
Systemic inflammation
Adipokines
Insulin and insulin-like growth factor
Diet and gut microbiome
Bariatric surgery and the risk of Barrett’s esophagus and esophageal adenocarcinoma
Conclusion
Disclosures
References
5 Obesity and esophageal dysmotility
Introduction
Impact of obesity on esophageal motility
Evaluation
Disorders of the esophagus
Distal esophageal spasm and hypercontractile esophagus
Diagnosis
Esophageal manometry
Barium esophagram
Treatment
Achalasia
Diagnosis
Endoscopy
Barium esophagram
Esophageal manometry
Treatment
Ineffective esophageal motility
Diagnosis
Treatment
Conclusion
References
6 Nonsurgical management of GERD in obesity
Introduction
Diet and lifestyle therapy
Diet
Lifestyle
Acid-suppression pharmacotherapy
Proton pump inhibitor
Histamine2 receptor antagonist
Potassium competitive acid blocker
Other pharmacotherapy
Summary
Disclosures
References
7 Endoscopic GERD therapeutics in obesity
Introduction
Endoscopic antireflux procedures
Radiofrequency therapy (Stretta)
Transoral incisionless fundoplication
Endoscopic antireflux procedures in patients with altered anatomy
Endoscopic weight loss procedures
Intragastric balloon
Endoscopic sleeve gastroplasty
Aspiration therapy
Summary
Conflicts of interest
Funding
Author contributions
References
8 Surgical therapy of gastroesophageal reflux disease and obesity
Introduction
Traditional antireflux surgery
Fundoplication and paraesophageal hernia repair
Lower esophageal sphincter augmentation
Radiofrequency sphincter augmentation
Magnetic sphincter augmentation
Metabolic and bariatric surgery in patients suffering from gastroesophageal reflux disease
Roux-en-Y gastric bypass
Vertical sleeve gastrectomy
Adjustable gastric banding
Endoluminal weight loss procedures
Roux-en-Y gastric bypass for failed antireflux surgery
Conclusion
References
9 Postbariatric surgery esophageal dysmotility
Introduction
Bariatric surgical procedures
Evaluation of dysphagia after bariatric surgery
Effects of bariatric surgery on esophageal motor function
Management of dysphagia after bariatric surgery
Conclusions
Conflicts of interest
References
10 Postbariatric surgery gastroesophageal reflux disease
Introduction
Pre-operative work up and procedure selection
Postbariatric surgery gastroesophageal reflux disease
Postsleeve gastrectomy considerations
Postduodenal switch considerations
Postgastric band considerations
Post-Roux-en-Y gastric bypass considerations
Postoperative surveillance
Conclusion
References
Index
