Evidence mapPaperPMID 40080355Full record

ArticleUpdates in surgery2025

Esophageal high-resolution manometry and 24 h pH-impedance monitoring normative values in patients with obesity candidate for bariatric and metabolic surgery.

Salvatore Tolone, Edoardo Vincenzo Savarino, Nicola De Bortoli, Francesco Saverio Lucido, Claudio Gambardella, Luigi Brusciano, Simona Parisi, Gianmattia Del Genio, Roberto Ruggiero, Ludovico Docimo

Abstract read
In one paragraph

Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Salvatore ToloneGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy. salvatore.tolone@unicampania.it.
Edoardo Vincenzo SavarinoDivision of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Nicola De BortoliDivision of Gastroenterology, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
Francesco Saverio LucidoGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Claudio GambardellaGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Luigi BruscianoGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Simona ParisiGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Gianmattia Del GenioGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Roberto RuggieroGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.
Ludovico DocimoGeneral, Mininvasive, Oncologic and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 5, 80131, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Obesity is linked to increased risk of gastroesophageal reflux disease (GERD) and esophageal motility disorders, both of which may impact outcomes in metabolic and bariatric surgery (MBS). GERD pathophysiology in obesity includes elevated intraabdominal pressure and altered esophagogastric junction (EGJ) function. High resolution manometry (HRM) and 24-h esophageal pH-impedance (MII-pH) monitoring are vital in evaluating GERD, yet normative values specific to populations with obesity are limited, risking misdiagnosis if lean data are used. This study establishes normative HRM and MII-pH values in asymptomatic individuals with obesity, compared to normal-weight controls, to guide accurate diagnosis and treatment. A retrospective analysis was conducted on asymptomatic patients with obesity (BMI ≥ 30) and normal-weight controls (BMI 20-25) who underwent HRM and MII-pH prior to MBS between 2015 and 2024. Exclusion criteria included GERD symptoms, esophagitis, and prior gastrointestinal surgery. Key HRM parameters (LES pressure, EGJ morphology) and MII-pH metrics (acid exposure time, reflux episodes) were recorded and analyzed. Of the 96 patients with obesity and 25 normal-weight participants, significant differences in HRM and MII-pH results were observed. Individuals with obesity showed increased intra-gastric pressure, gastroesophageal pressure gradient, and higher acid exposure time. While LES pressure and EGJ morphology were similar to controls, participants with obesity exhibited distinct reflux patterns, especially postprandial, suggesting obesity-specific physiological changes. This study establishes normative HRM and MII-pH values for asymptomatic individuals with obesity, highlighting critical differences from normal-weight controls. Obesity-specific diagnostic criteria are essential for accurate GERD diagnosis, particularly for MBS candidates, to improve management and predict potential postoperative complications.

Indexed as

Bariatric SurgeryEsophageal pH MonitoringEsophagusGastroesophageal RefluxManometryObesityAdultElectric ImpedanceEsophagogastric JunctionFemaleHumansMaleMiddle AgedReference ValuesRetrospective StudiesBariatric surgeryGERDHigh-resolution manometrypH-impedance monitoring

Identifiers

PMID40080355
PMCPMC12540595

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.