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Gastric Banding Resolves GERD in Some, Aggravates Others

About a third of patients remain symptomatic after surgery

TUESDAY, March 21 (HealthDay News) -- While adjustable gastric banding can resolve gastroesophageal reflux disease (GERD) in many obese patients, a subset with poor esophageal body motility may end up with symptoms that are worse, according to a study in the March issue of the Archives of Surgery. Alternative obesity procedures should be considered for such patients, the authors say.

Alexander Klaus, M.D., of Medical University Innsbruck in Austria, and colleagues studied 587 patients who had a mean body mass index of 46.7 who underwent laparoscopic adjustable gastric banding between 1996 and 2002. About 28 percent, or 164 patients, had preoperative GERD symptoms.

Overall, GERD symptoms resolved after the procedure in 112 patients, or 68.3 percent. Fifty-two patients (31.7 percent) remained symptomatic after implantation. Patients with symptoms had poorer esophageal body motility than symptom-free patients (20.8 percent versus 12.8 percent). Patients who continued to have symptoms also had worsening dysphagia and regurgitation after the procedure.

While adjustable gastric banding "provides a sufficient anti-reflux barrier in most of the obese patients with GERD," the authors write, it may "aggravate GERD symptoms and esophageal dilatation" in others. "Alternative bariatric surgical procedures should be considered in these patients," they conclude.

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