ArticleObesity surgery2025
Concordant and Discordant Interrelationships of the GERD Triad of Symptoms, Endoscopy Findings, and Histopathological Changes Over Time after One Anastomosis Gastric Bypass.
Article in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundReflux-related symptoms, upper endoscopy (UE), and histopathology findings comprise a triad of changes of gastro-esophageal reflux disease (GERD) following one anastomosis gastric bypass (OAGB). However, the evolution and interplay between these changes across time have not been sufficiently evaluated.
methodsThis study is a retrospective analysis of the GERD triad in 150 patients using GerdQ questionnaire, UE, and histopathology at year 1 and year 3 after OAGB. Evolution of the GERD triad was explored, covering five areas: evolution of changes in the GERD triad over time; relationships and correlations between changes in the GERD triad components in the form of concordance or discordance among these components; subsets of patient demographics or time intervals that necessitate heightened awareness for post-OAGB reflux-related abnormalities; characteristics defining concordant compared to discordant cases; and potential predictors that increase the likelihood of discordance.
settingUniversity hospital, Alexandria, Egypt.
resultsMean age was 34.7 years, with 75.3% females. At year 1, 25.7% were symptomatic, yet 62.5% and 65.3% of patients had UE and histopathology abnormalities respectively. Hence, 36.8% of patients with abnormal UE and 39.6% with abnormal histopathology were asymptomatic. At year 3, 55.6% were symptomatic, yet 75.8% and 78.2% had UE and histopathological abnormalities respectively. Discordant cases comprised 39.6% and 22.6% of patients at years 1 and 3 respectively. There were no significant differences in patient characteristics between concordant and discordant cases at years 1 and 3. Although symptoms were significantly one-third lower at year 1 compared to year 3, the likelihood of discordance was significantly higher at year 1 (OR = 2.81, 95% CI = 1.64-4.80, p < 0.001) and in patients with elevated hemoglobin (OR = 1.37, 95% CI = 1.10-1.71, p = 0.005).
conclusionThere was variable evolution of the GERD triad. Concordant cases posed no significant clinical threats, while discordant cases require a high index of suspicion. At year 1, there were more asymptomatic patients with more discordance, while the higher likelihood of symptoms at year 3 calls for extended follow up beyond year 3.
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