Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul;32(7):2417-2425.
doi: 10.1007/s11695-022-06099-5. Epub 2022 May 16.

Gastrointestinal Symptomatology as a Predictor of Esophagogastroduodenoscopy Findings in the Bariatric Population: a Retrospective Cohort Study with Review of the Literature

Antoine Rioux  1 , Audrey Viger  2 , François-Charles Malo  3   4
Affiliations
Review

Gastrointestinal Symptomatology as a Predictor of Esophagogastroduodenoscopy Findings in the Bariatric Population: a Retrospective Cohort Study with Review of the Literature

Antoine Rioux et al. Obes Surg. 2022 Jul.

Abstract

Purpose: Esophagogastroduodenoscopy (EGD) is a useful test to diagnose significant pathologies before bariatric surgery. Controversy remains about its role in the preoperative workup of asymptomatic patients. This study aims to describe findings and changes in the management related to EGD. A secondary objective was to review the existing literature on the subject to analyze the role of patients' gastrointestinal symptomatology as an indication to undergo a preoperative EGD.

Material and methods: A retrospective chart review of patients operated at the Centre hospitalier universitaire de Sherbrooke (CHUS) since the opening of the Clinique médico-chirurgicale du traitement de l'obésité (CMCTO) was conducted, alongside a review of the literature. Pathologic findings on EGD were classified into 4 groups (groups 0 to 3). Results of this study were combined with literature to calculate weighted averages of global sensitivity, specificity, positive/negative predictive values, and likelihood ratios of gastrointestinal symptomatology as a predictor of pathologic endoscopy findings.

Results: A total of 737 patients were included in the study. Of those, 236 (35,7%) were considered symptomatic. Significant pathologic findings on EGD (group 2 and 3) were present for 270 patients (36.6%). Changes in medical management occurred in 22.8% of cases and in surgical management in 3.5% of cases. When combining past studies with the present one, the presence of symptoms had a sensitivity of 57.4% and a specificity of 82.4% for findings on EGD.

Conclusion: Considering that this exam is relatively safe, that it allows uncovering a great number of pathologies altering management, and that symptoms are not a good screening test to decide of its indication, the authors recommend that all bariatric surgery patients undergo an EGD in their preoperative workup.

Keywords: Bariatric surgery; Esophagogastroduodenoscopy; Gastrointestinal symptoms; Preoperative.

PubMed Disclaimer

References

    1. CDC. Obesity is a common, serious, and costly disease. Centers for Disease Control and Prevention https://www.cdc.gov/obesity/data/adult.html (2020).
    1. El-Serag HB, Graham DY, Satia JA, et al. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005;100:1243–50. - PubMed
    1. Gerson LB. Impact of obesity on endoscopy. Gastrointest Endosc. 2009;70:758–62. - PubMed
    1. Menon S, Trudgill N. Risk factors in the aetiology of hiatus hernia: a meta-analysis. Eur J Gastroenterol Hepatol. 2011;23:133–8. - PubMed
    1. Csendes A et al. Clinical, endoscopic, and histologic findings at the distal esophagus and stomach before and late (10.5 Years) after laparoscopic sleeve gastrectomy: results of a prospective study with 93% follow-up. Obes Surg. 2019;29:3809–17. - PubMed

LinkOut - more resources