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A point for discussion regarding OAGB is acid and non-acid reflux in mid- and long-term follow-up. The aim of this study was to objectively evaluate reflux and esophagus motility by comparing pre- and postoperative results of 24-h pH-metry, high-resolution manometry (HRM), and gastroscopy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>Cross-sectional study and university hospital based.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This study includes primary OAGB patients operated at the Medical University of Vienna before 31st December 2022. After a mean follow-up of 4.1\u2009\u00b1\u20092.9\u00a0years, the preoperative examinations were repeated. Additionally, history of weight, remission of obesity-related complications (ORC), and quality of life (QOL) were evaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 50 patients were included in this study and went through all examinations. Preoperative weight was 125.5\u2009\u00b1\u200921.0\u00a0kg with a BMI of 44.6\u2009\u00b1\u20095.4\u00a0kg\/m<jats:sup>2<\/jats:sup> and total weight loss after 4.1\u2009\u00b1\u20092.9\u00a0years was 37.1\u2009\u00b1\u20098.1%. Remission of ORC and QOL outcomes was successful in all categories. Gastroscopy showed anastomositis, esophagitis, Barrett\u2019s esophagus, and bile in the pouch in 38.0%, 34.0%, 6.0%, and 48.0%, respectively. In HRM, the postoperative lower esophageal sphincter pressure was 29.6\u2009\u00b1\u200915.1\u00a0mmHg (unchanged to preoperative). The total number of refluxes was equal to preoperative, whereas decreased acid refluxes were replaced by increasing non-acid refluxes. Impedance-24-h pH-metry showed that acid exposure time of the esophagus and DeMeester score decreased significantly to 1.6\u2009\u00b1\u20091.4% (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and 10.3\u2009\u00b1\u20099.6 (<jats:italic>p<\/jats:italic>\u2009=\u20090.046).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study has shown decreased rates of acid reflux and increased rates of non-acid reflux after a mid-term outcome of primary OAGB patients. Gastroscopy showed significant signs of chronic reflux exposure of the anastomosis, the pouch, and the distal esophagus, even in asymptomatic patients. General follow-up visits in patients after OAGB should be considered.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11606-7","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T21:31:22Z","timestamp":1739914282000},"page":"2335-2345","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Update on esophageal function, acid and non-acid reflux after one-anastomosis gastric bypass (OAGB): high-resolution manometry, impedance-24-h pH-metry, and gastroscopy in a prospective mid-term study"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5229-5096","authenticated-orcid":false,"given":"D. 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M. Felsenreich received a research grant by EAES (European Association for the Endoscopic Surgery and other interventional techniques). G. Prager reports educational grants from Medtronic and Novo Nordisk as well as speakers\u2019 fees by Medtronic. N. Vock, M. L. Zach, I. Kristo, J. Jedamzik, C. Bichler, J. Eichelter, M. Mairinger, L. Gensthaler, L. Nixdorf, P. Richwien, L. Pedarnig, and F. B. Langer have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}