Objective:

To evaluate the temporal evolution and interrelationships of GERD symptoms, endoscopic findings, and histopathological changes in patients after One-Anastomosis Gastric Bypass (OAGB).

Key Findings:

• Asymptomatic patients exhibited inflammatory changes in the gastrojejunostomy, gastric pouch, and distal esophagus, indicating potential underdiagnosis of GERD.
• Symptoms alone may not reliably diagnose GERD post-OAGB; routine UE and biopsy are recommended for accurate assessment.
• There are discordant findings between GERD symptoms and histological changes in OAGB patients, highlighting the need for comprehensive evaluations.

Interpretation:

The study highlights the complexity of GERD diagnosis post-OAGB, indicating that symptoms, endoscopic findings, and histopathological changes may not align, necessitating comprehensive evaluations for accurate diagnosis.

Limitations:

• The study is retrospective and may have inherent biases that could affect the reliability of the findings.
• Limited generalizability due to the specific patient population and setting, which may not reflect broader demographics.
• Potential variability in symptom reporting and interpretation of endoscopic findings could influence results.

Conclusion:

This study is the first to systematically analyze the interrelationships of GERD symptoms, endoscopic findings, and histopathological changes over time after OAGB, emphasizing the need for routine evaluations to better understand GERD post-surgery and improve patient outcomes.