Publikation

The contribution of intrabolus pressure to symptoms induced by gastric banding

Wissenschaftlicher Artikel/Review - 01.03.2014

Bereiche
PubMed

Zitation
Preissler C, Krieger-Grübel C, Borovicka J, Fried M, Tutuian R. The contribution of intrabolus pressure to symptoms induced by gastric banding. J Gastrointestin Liver Dis 2014; 23:13-7.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
J Gastrointestin Liver Dis 2014; 23
Veröffentlichungsdatum
01.03.2014
eISSN (Online)
1842-1121
Seiten
13-7
Kurzbeschreibung/Zielsetzung

BACKGROUND & AIMS
Mechanisms that ultimately lead to dysphagia are still not totally clear. Patients with laparoscopic gastric banding (LAGB) often complain about dysphagia, regurgitation and heartburn. Our aim was to evaluate the contribution of intrabolus pressure to symptoms of gastric banding.

METHODS
This study investigated 30 patients with LAGB before and 3 months after conversion to Roux-en-Y gastric bypass (RYGB), evaluating symptoms with a 7-point-Likert-scale and esophageal peristalsis, esophageal bolus transit and intrabolus pressure changes using combined impedance-manometry.

RESULTS
Conversion from LAGB to RYGB leads to a significant reduction in dysphagia (1.9 +/- 0.4 vs. 0.0 +/- 0.0; p< 0.01) and regurgitation (4.2 +/- 0.4 vs. 0.1 +/- 0.1; p< 0.01) symptom scores. For liquid swallows we found a modest but significant correlation between the intensity of dysphagia and intrabolus pressure (r=0.11; p<0.05) and the intensity of regurgitation and intrabolus pressure for viscous swallows (r=0.12, p<0.05) in patients with LAGB. There was a significant (p< 0.05) reduction in intrabolus pressure at 5 cm above LES before (liquid 10.6 +/-1.0; viscous 13.5 +/- 1.5) and after (liquid 6.4 +/- 0.6; viscous 10.5 +/- 0.9) conversion from LAGB to RYGB.

CONCLUSION
Current data suggest that intraesophageal pressure during bolus presence in the distal esophagus contributes to the development but not to the intensity of dysphagia and regurgitation.