Oesophageal dysfunction and disease in obesity

摘要

Patients with morbid obesity suffer a wide range of symptoms that relate to their oesophagus and stomach. It is rather paradoxical that patients who are overweight suffer the symptoms of difficulty in swallowing, pain during eating or pain after eating, because the symptoms of difficulty eating do not translate into weight reduction. There are a range of underlying causes that include gastro-oesophageal reflux disease, dysmotility in the oesophagus, peptic ulceration and the nature and pattern of dietary intake. In addition the surgical treatments used for morbid obesity cause similar symptoms from gastric bands leading to dysphagia or reflux from being too tight or from erosion into the stomach, from balloons being displaced and bypass complications. Serious oesophageal conditions occur more frequently in patients with obesity such as Barrett’s oesophagus and Adenocarcinoma of the oesophagus. This article reviews the literature to highlight the range of potential problems from oesophageal symptoms and disease and how they can be managed in the context of morbid obesity.