Gastric Procedure Alleviates GERD Symptoms in Obesity

TOPLINE:

In patients with obesity, endoscopic gastric remodeling (EGR) — a minimally invasive procedure — is safe and effective in relieving both typical and atypical gastroesophageal reflux disease (GERD) symptoms at 12 months post-procedure, while also reducing proton pump inhibitor (PPI) use.

METHODOLOGY:

• EGR is a minimally invasive alternative to bariatric surgery that reduces gastric volume by approximately 70%, though its effect on GERD symptoms remains unclear.
• Researchers conducted a prospective cohort study at a tertiary referral bariatric center to examine EGR’s effect on GERD symptoms in patients with at least one obesity-related comorbidity.
• Patients completed GERD and health-related assessments before and 12 months after the procedure.

TAKEAWAY:

• Researchers included 50 patients (mean age, 41 years; mean BMI at baseline, 38.4; 95.8% women; 44% with GERD) who underwent EGR using either endoscopic suturing (16%) or plication (84%).
• All patients successfully underwent EGR without any serious adverse events.
• Between baseline and 12 months post-procedure, the mean Reflux Symptom Index score decreased from 5.1 to 3.8 (P = .007) and PPI use from 38% to 20% (P = .047).
• The presence of a hiatal hernia predicted a greater alleviation of GERD symptoms.

IN PRACTICE:

“EGR may be considered a preferred option to co-manage both obesity and GERD, particularly in the lower obesity class,” the authors wrote. 

SOURCE:

This study was led by Pichamol Jirapinyo, MD, MPH, Brigham and Women’s Hospital, Boston, and published online in Clinical and Translational Gastroenterology.

LIMITATIONS:

This study did not include esophageal pH monitoring before or after EGR. Most participants were non-Hispanic women, which may have limited generalizability. Factors such as dietary modifications and medication use were not assessed.

DISCLOSURES:

The study received no external funding. Several authors reported being consultants; receiving research support, grants, or royalties; and having other ties with pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.