The Impact of Bariatric Procedures on Esophageal Motility

2021 ◽  
Vol 1 (3) ◽  
pp. 268-276
Author(s):  
Fernando A. M. Herbella ◽  
Marco G. Patti
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Esophageal Motility ◽  
Adjustable Gastric Banding ◽  
Different Types ◽  
Resting Pressure ◽  
Esophageal Sphincter ◽  
The Impact ◽  
The Relationship

Bariatric operations may cause or cure gastroesophageal reflux disease (GERD). The comprehension of esophageal motility following different types of bariatric procedures may help understand the relationship between GERD and bariatric surgery. This review focused on the impact of bariatric procedures on esophageal motility. We found that lower esophageal sphincter resting pressure is increased after adjustable gastric banding; is unaltered or decreased after Roux-en-Y gastric bypass; and is decreased after sleeve gastrectomy. Lower esophageal sphincter relaxation may be abnormal after all these procedures. Esophageal body contractility is worsened after sleeve gastrectomy.

scholarly journals Impact of Laparoscopic Sleeve Gastrectomy on Esophageal Physiology

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrada-Loredana Popescu ◽  
Florentina Ioniţa-Radu ◽  
Mariana Jinga ◽  
Vasile-Daniel Balaban ◽  
Raluca-Simona Costache ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
High Resolution ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Morbidly Obese ◽  
Esophageal Physiology ◽  
Esophageal Sphincter ◽  
The Impact

Abstract Introduction: Laparoscopic sleeve gastrectomy (LSG) is a popular weight loss surgery technique, but the impact on esophageal physiology and esophagogastric junction is still debatable. The aim of our study was to evaluate the manometric changes of the lower esophageal sphincter (LES) after LSG in order to indicate LES manometry pre- procedure. Methods: In a prospective study we evaluated clinically, with upper gastrointestinal endoscopy, and high-resolution esophageal manometry 45 morbidly obese patients before, and 6-12 months after LSG. Results: The BMI (body mass index) decreased from 46.28±5.79 kg/m2 to 32.28±4.65 kg/m2 postoperatively (p <0.01), with a reduction of ~14 kg/m2 of BMI, 39.9 (±11.9) kg body weight and 29.9 (± 6.2)% of the TWL (Total Weight Loss index), in a median interval of 7.9 months. Gastroesophageal reflux disease (GERD) prevalence increased from 17.8% to 31.1% postoperatively, with new GERD onset in 22.2%, but mild symptomatology (the median GERDHRQL score increased from 1.56 to 2.84 points). Postoperatory reflux was associated with lower esophageal sphincter (LES) hypotonia, shortening of LES length and IIGP (increased intragastric pressure). Hiatal hernia repair rate was 17.8%, and proton pump inhibitor consumption 20%. After weight loss, the 10 cases of esophagitis discovered preoperatively cured, but 3 patients were diagnosed with de novo esophagitis. The prevalence of manometric dysmotility after LSG was 28.9%, lower than before surgery (44.4%). Conclusion: Even if GERD remains the main limitation of LSG, the high-resolution esophageal manometry has proved useful and should be implemented in morbidly obese evaluation protocol, to better select the bariatric procedure.

Effects of Obesity Surgery on GERD and Esophageal Motility

2022 ◽  
pp. 263451612110691
Author(s):  
Anh D. Nguyen
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Laparoscopic Adjustable Gastric Banding ◽  
Esophageal Motility ◽  
Adjustable Gastric Banding ◽  
Esophageal Dysmotility ◽  
Obese Population ◽  
Prevalence Of Obesity

With the rising prevalence of obesity, bariatric surgery has become an increasingly popular treatment option. However, bariatric surgery can contribute to esophageal dysmotility and lead to worsening or development of GERD, two conditions that are already frequently seen in the obese population. We review the effects of the various types of bariatric surgeries on the esophagus, specifically focusing on sleeve gastrectomy, Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding.

scholarly journals Orosensory Perception of Fat/Sweet Stimuli and Appetite-Regulating Peptides before and after Sleeve Gastrectomy or Gastric Bypass in Adult Women with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 878
Author(s):  
Arnaud Bernard ◽  
Johanne Le Beyec-Le Bihan ◽  
Loredana Radoi ◽  
Muriel Coupaye ◽  
Ouidad Sami ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gut Hormones ◽  
Sweet Taste ◽  
Taste Perception ◽  
Taste Sensitivity ◽  
Adult Women ◽  
Before And After ◽  
The Impact

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.

scholarly journals THE PARTICIPATION OF THE NITRERGIC PATHWAY IN INCREASED RATE OF TRANSITORY RELAXATION OF LOWER ESOPHAGEAL SPHINCTER INDUCED BY RECTAL DISTENSION IN DOGS

2014 ◽  
Vol 51 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Michel Santos PALHETA ◽  
José Ronaldo Vasconcelos da GRAÇA ◽  
Armênio Aguiar dos SANTOS ◽  
Liziane Hermógenes LOPES ◽  
Raimundo Campos PALHETA JÚNIOR ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Lower Esophageal Sphincter ◽  
Esophageal Motility ◽  
Control Group ◽  
Rectal Distension ◽  
Evaluation Protocol ◽  
Lower Esophageal Sphincter Relaxation ◽  
Respective Control Group ◽  
Esophageal Sphincter ◽  
Pre Treatment

ContextThe rectal distension in dogs increases the rate of transitory lower esophageal sphincter relaxation considered the main factor causing gastroesophageal reflux.ObjectivesThe aim of this study was evaluate the participation of the nitrergic pathway in the increased transitory lower esophageal sphincter relaxation rate induced by rectal distension in anesthetized dogs.MethodsMale mongrel dogs (n = 21), weighing 10-15 kg, were fasted for 12 hours, with water ad libitum. Thereafter, they were anesthetized (ketamine 10 mg.Kg-1+ xylazine 20 mg.Kg-1), so as to carry out the esophageal motility evaluation protocol during 120 min. After a 30-minute basal period, the animals were randomly intravenous treated whith: saline solution 0.15M (1ml.Kg-1), L-NAME (3 mg.Kg-1), L-NAME (3 mg.Kg-1) + L-Arginine (200 mg.Kg-1), glibenclamide (1 mg.Kg-1) or methylene blue (3 mg.Kg-1). Forty-five min after these pre-treatments, the rectum was distended (rectal distension, 5 mL.Kg-1) or not (control) with a latex balloon, with changes in the esophageal motility recorded over 45 min. Data were analyzed using ANOVA followed by Student Newman-Keuls test.ResultsIn comparison to the respective control group, rectal distension induces an increase in transitory lower esophageal sphincter relaxation. Pre-treatment with L-NAME or methylene blue prevents (P<0.05) this phenomenon, which is reversible by L-Arginine plus L-NAME. However, pretreating with glibenclamide failed to abolish this process.ConclusionsTherefore, these experiments suggested, that rectal distension increases transitory lower esophageal sphincter relaxation in dogs via through nitrergic pathways.

Improving Assessments of Another Auditor's Competence

2009 ◽  
Vol 28 (1) ◽  
pp. 53-78 ◽  
Author(s):  
Noel Harding ◽  
Ken T. Trotman
Keyword(s):  
Group Feedback ◽  
Potential Intervention ◽  
Outcome Feedback ◽  
Average Group ◽  
Different Types ◽  
Specific Feedback ◽  
Specific Outcome ◽  
The Impact ◽  
The Relationship ◽  
Audit Effectiveness

SUMMARY: Auditing standards require auditors to assess the competence of their colleagues. However, previous studies have shown that auditors' assessments of their colleagues' competence are inaccurate and overconfident, potentially leading to a reduction in audit effectiveness. In two related studies, we investigate both the process by which these assessments are made and a potential intervention aimed at improving these judgments. In study 1, we investigate the anchors used by senior auditors in assessing the competence of their subordinates and peers, and find that the anchors vary depending on the familiarity of the audit senior with their colleague. These findings inform study 2, which investigates the impact of different types of outcome feedback on auditors' assessments of another auditor's competence. We find that the effects of individual-specific feedback and average-group feedback will be contingent on the nature of the relationship between the assessor and assessee. Specifically, individual-specific outcome feedback is effective in reducing overconfidence when assessing the competence of a colleague with whom the assessor has previously worked, but not an unfamiliar colleague. When assessing the competence of an unfamiliar colleague, we find that average-group outcome feedback is effective in reducing overconfidence. Our results complement and extend earlier theory by showing that individuals, in assessing a colleague's competence, use anchors in addition to the competence of the assessor.

scholarly journals Research on Mediating Mechanisms and the Impact on Food Provision Services in Poor Areas from the Perspective of Stakeholders

2021 ◽  
Vol 18 (19) ◽  
pp. 10510
Author(s):  
Tianwei Geng ◽  
Hai Chen ◽  
Di Liu ◽  
Qinqin Shi ◽  
Hang Zhang
Keyword(s):  
Ecosystem Service ◽  
Behavioral Responses ◽  
The Loess Plateau ◽  
Trade Offs ◽  
Different Types ◽  
Mediating Mechanisms ◽  
The Common ◽  
Food Provision ◽  
The Impact ◽  
The Relationship

Exploring and analyzing the common demands and behavioral responses of different stakeholders is important for revealing the mediating mechanisms of ecosystem service (ES) and realizing the management and sustainable supply of ES. This study took Mizhi County, a poverty-stricken area on the Loess Plateau in China, as an example. First, the main stakeholders, common demands, and behavioral responses in the food provision services were identified. Second, the relationship among stakeholders was analyzed. Finally, this study summarized three types of mediating mechanisms of food provision services and analyzed the influence of the different types of mediating mechanisms. The main conclusions are as follows: (1) Five main stakeholders in the study area were identified: government, farmers, enterprises, cooperatives, and middlemen. (2) Increasing farmers’ income is the common demand of most stakeholders in the study area, and this common demand has different effects on the behavioral responses of different stakeholders. (3) There are three types of mediating mechanisms in the study area: government + farmers mediating corn and mutton, government + enterprises mediating millet, and government + cooperatives mediating apples. On this basis, the effects of the different types of mediating mechanisms on variations in food yield, and trade-offs and synergies in typical townships, were analyzed.

Energy Efficiency of Vehicles

2020 ◽  
Author(s):  
Doug Carroll
Keyword(s):  
Energy Efficiency ◽  
Scientific Knowledge ◽  
Fuel Economy ◽  
Environmental Consequences ◽  
Energy Models ◽  
The World ◽  
Different Types ◽  
The Impact ◽  
The Relationship ◽  
Rational Decisions

Energy Efficiency of Vehicles educates readers about energy and the environment and the relationship between the energy we use and the environment. The world is at a point in time when people need to make very important decisions about energy in the next few decades. This book enables readers to utilize our scientific knowledge to make good rational decisions. Energy Efficiency of Vehicles provides information on: Calculations related to energy, power, and efficiency, and the impact of using different types of energy on the environment. Environmental consequences of consuming energy. Models related to impact of city driving on the energy efficiency and fuel economy of cars and trucks.

ASSESSMENT OF PRODUCTION FUNCTIONS AND ANALYSIS OF THE IMPACT OF PRODUCTION FACTORS ON THE MAIN INDICATORS AGRICULTURE OF THE REPUBLIC OF DAGESTAN

2020 ◽  
Vol 4 (12) ◽  
pp. 38-42
Author(s):  
N. M. CHAPAEV ◽  
Keyword(s):  
Agricultural Production ◽  
Factor Models ◽  
Production Functions ◽  
Agricultural Enterprises ◽  
Republic Of Moldova ◽  
Production Factors ◽  
Different Types ◽  
The Republic ◽  
The Impact ◽  
The Relationship

This article assesses the relationship and dependence between the main economic indicators of agricultural enterprises of the Ministry of agriculture of the Republic of Moldova for different years, models of production functions of different types are constructed. The parameters and characteristics for two-factor models expressing the dependence of agricultural production on the number of people employed in agriculture are given.

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