Laryngopharyngeal Reflux Among Patients Undergoing Bariatric Surgery

Purpose The effect of altered subsphincteric gastric volume and pressure after bariatric surgery on laryngopharyngeal reflux (LPR) remains largely unknown. This was a cross-sectional pilot study conducted between January 2018 and January 2019 to identify changes in LPR symptoms and signs in bariatri...

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Bibliographic Details
Published in:	Obesity surgery Vol. 31; no. 8; pp. 3749 - 3757
Main Authors:	Ramasamy, Purushotman, Kumarasamy, Vigneswaran, Singh, Avatar Singh Mohan, Abu Bakar, Mohd Zulkiflee B., Narayanan, Prepageran, Ganapathy, Shubash Shander, Ramasamy, Umasangar, Vinayak, C. Rajkumar
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-08-2021 Springer Nature B.V
Subjects:	Adult Bariatric Surgery Cross-Sectional Studies Female Gastrointestinal surgery Humans Laryngopharyngeal Reflux - etiology Male Medicine Medicine & Public Health Middle Aged Obesity, Morbid - surgery Original Contributions Pilot Projects Surgery Reflux finding score Laryngopharyngeal reflux Reflux symptom index Bariatric surgery Gastric bypass Sleeve gastrectomy
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Summary:	Purpose The effect of altered subsphincteric gastric volume and pressure after bariatric surgery on laryngopharyngeal reflux (LPR) remains largely unknown. This was a cross-sectional pilot study conducted between January 2018 and January 2019 to identify changes in LPR symptoms and signs in bariatric surgery patients presurgery and postsurgery. Materials and Methods Thirty-four patients listed for bariatric surgery in a single tertiary referral center were recruited, where 31 (77.4% female, mean age 46.3 ± 8.9 years) fulfilled the eligibility criteria. Of the eligible patients, 54.8% and 45.2% underwent sleeve gastrectomy (SG) and gastric bypass (GB), respectively. LPR symptoms were assessed using the self-reported reflux symptom index (RSI). Video-recorded endolaryngeal signs were scored using the reflux finding score (RFS) by two blinded otolaryngologists. Patients’ presurgical and 3-month postsurgical body mass index (BMI), RSI, and RFS were determined. Patients were deemed as having LPR when RSI > 13 or RFS > 7. Results There was a significant correlation between the postsurgical RSI and RFS changes (Pearson’s r = 0.474, p = 0.007). Of the 31 patients, 12.9% (RSI) and 6.4% (RFS) recovered from preexisting LPR, whereas 22.6% (RSI) and 3.2% (RFS) developed new de novo LPR postsurgery. The postsurgical mean RFS change improved significantly in the GB group compared with that of the SG group ( p < 0.05). Conclusion LPR is best assessed clinically using a multimodal approach (RSI and RFS). Bariatric surgery may worsen or lead to de novo LPR. Recognizing the LPR outcomes in these patients is paramount for optimal voice, speech, and swallowing functions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0960-8923 1708-0428
DOI:	10.1007/s11695-021-05492-w