Severity assessment of gastroesophageal reflux disease symptoms before and after sleeve gastrectomy

Background The effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) has been a controversial issue. Studies on this aspect are limited, and most of the published studies are not conclusive. Therefore, a prospective study was designed for further assessment of the problem. The objective of this study was to assess the effect of LSG on GERD symptoms using a questionnaire. Patients and methods Thirty morbidly obese patients undergoing LSG were assessed for GERD severity using the Carlsson-Dent Questionnaire (CDQ) before and after surgery at monthly intervals for 3 months postoperatively. Results The mean preoperative weight and BMI were 131.7 kg and 46.76 kg/m2, respectively. The mean percent excess weight loss was 10.8% at 1 month, 18.8% at 2 months, and 25.5% at 3 months. Postoperative CDQ scores had exhibited a highly significant decline at different times of measurement, and its percentage of change values was -19.07 +/- 33.61, -56.39 +/- 44.13, and -70.60 +/- 46.31 at 1, 2, and 3 months, respectively. There was no significant correlation comparing either CDQ score or CDQ score percent of change with weight and BMI change at 1, 2, and 3 months postoperatively. However, a correlation study was done between CDQ scores at 1, 2, and 3 months with the other studied parameters, and it declared the presence of a significant positive correlation between CDQ score % of change after 2 months and fasting blood sugar (P=0.020) and albumin (P=0.004). Conclusion There is an improvement in GERD as assessed by the symptom questionnaire (CDQ) in morbidly obese patients after LSG. Accordingly, the presence of GERD should not be considered a contraindication for sleeve gastrectomy. However, it remains a crucial debate and needs objective evaluation and long-term follow-up.