{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:26:46Z","timestamp":1786739206110,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>There is a strong association between gastro-oesophageal reflux disease and morbid obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Two hundred and eleven morbidly obese patients operated between September 2007 and June 2017 were retrospectively reviewed. All patients underwent pre-operative upper gastrointestinal endoscopy and assessment by reflux symptomatic score questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the total 211 patients, 156 (73.94%) were females; mean body mass index of the cohort was 46.23 \u00b1 3.1 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . There was no evidence of Barrett's oesophagus or malignancy on pre-operative endoscopy. 63.04% of the patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 133) in the study cohort had normal endoscopy. Pre-operative evaluation by reflux symptom score (RSS) questionnaire revealed no evidence of gastro-oesophageal reflux disease in 61.13% of patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 129). The total number of patients with symptoms was 82 (38.86%). They were further divided into two categories based on severity of symptoms, namely, mild + moderate 60 (73.17%) and severe + very severe 22 (26.83%). From the cohort of symptomatic patients, the sub-cohort of 60 mild + moderate symptomatic patients had equal number of patients with normal 30 (50%) and abnormal endoscopy 30 (50%). In the sub-cohort of patients with severe + very severe symptoms (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 22; 26.83%), endoscopy was abnormal in 6 (27.7%) patients. Whereas, out of 129 (61.13%) asymptomatic patients, one-third (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 42) had abnormal endoscopy. The weighted kappa score was used between pre-operative endoscopic findings and RSS was statistically not significant (\n                      <jats:italic toggle=\"yes\">k<\/jats:italic>\n                      - 0.0986).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Pre-operative endoscopy is a must in all bariatric patients as significant percentage of asymptomatic patients can have abnormal endoscopy and vice versa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_167_19","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T08:31:04Z","timestamp":1599899464000},"page":"322-328","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Correlation between pre-operative endoscopic findings with reflux symptom score for 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