Prevalence and Predictors of Esophageal Reflux Disease after Bariatric Surgery: A Single Center Experience

Background: Bariatric surgery effectively treats morbid obesity but increases gastroesophageal reflux disease (GERD) risk 2-2.5 times versus the general population, requiring careful postoperative monitoring. Aim of Study: To estimate the occurrence and predictors of esophageal reflux disease after different bariatric procedures Patients and Methods: This retrospective research has been performed at the Gastrointestinal Surgical Center (GISC), Man-soura University Hospitals, Mansoura City, Egypt. It included data from cases who had bariatric surgery at GISC among Jan-uary 2015 and April 2022. These patients were contacted for follow-up. Results: The study revealed comparable conservative management rates for de novo GERD across procedures: Laparoscopic sleeve gastrectomy (LSG) (40%), single anas-tomosis sleeve jejunal (SASJ) (27.3%), and one anastomosis gastric bypass (OAGB) (31.2%; p=0.518). While demograph-ics showed no differences, higher BMI (60.33 vs 47.06kg/m2, p-value below 0.001) and rapid weight loss (65.4% vs 24.8%, p-value below 0.001) predicted GERD. Regression analy-sis confirmed rapid weight loss (OR=2.36), high Body Mass Index (BMI) (OR=3.69), and vomiting (OR=3.6) as risk fac-tors (all p≤0.002), with 12-month weight loss being protective (OR=0.69). GERD patients showed better hypertension (HTN) resolution (22.2% vs 12.6%, p=0.016) but more vomiting (43.6% vs 12%, p<0.001). Conclusion: Sleeve gastrectomy carried the highest de novo GERD risk. Both procedure type and patient factors (high BMI, rapid weight loss) significantly influenced GERD devel-opment, necessitating individualized postoperative monitoring.