ESOPHAGEAL MOTILITY AFTER GASTRIC BYPASS IN ROUX-EN-Y FOR MORBID OBESITY: HIGH RESOLUTION MANOMETRY FINDINGS

Background: Bariatric operations may alter esophageal motility; however, there is a paucity of studies of the esophageal motility with high resolution manometry. Aim: To study patients after Roux-en-Y gastric bypass for morbid obesity with high resolution motility. Methods: Were included 18 asymptomatic patients (17 women, mean age 53 years) after undergoing to Roux-en-Y gastric bypass for morbid obesity. All patients underwent high resolution motility after a mean follow-up of three years after the operation. Results: The mean pressure of the lower esophageal sphincter was 18 +/- 13 (range 0-51) mmHg. Seven (39%) patients had a hypotonic sphincter and one (5%) hypertonicity. Sphincter relaxation was abnormal in one patient. Total and abdominal lower esophageal sphincter length was 4 +/- 1 (1-7) cm e 2 +/- 1 (0-3) cm, respectively. Esophageal body distal amplitude (average measurements at 3 and 7 cm above the lower esophageal sphincter) was 77 +/- 22 (40-120) mmHg. One (5%) patient had hypocontractility. Peristaltic waves were found in 95 +/- 0% (60-100). The upper esophageal sphincter basal pressure was 118 +/- 82 (33 - 334) mmHg; one (5%) patient (5%) had a hypotonic upper sphincter and eight (44%) hypertonicity. Conclusion: After gastric bypass in Roux-en-Y occurs significant lower esophageal sphincter hypotonia and upper esophageal sphincter hypertonia.