Objective:

To assess the effect of primary Roux-en-Y gastric bypass (RYGB) on gastro-oesophageal reflux disease (GORD) in patients with obesity, highlighting the significance of GORD as a common comorbidity in obesity.

Key Findings:

• RYGB can lead to improvement in GORD symptoms in some patients, with specific data to support this.
• The prevalence of new or worsening GORD symptoms post-RYGB remains uncertain, necessitating further investigation.
• Discontinuation of proton-pump inhibitors (PPI) therapy after RYGB is unclear, highlighting the need for more data.

Interpretation:

The findings suggest that while RYGB may improve GORD symptoms for some patients, the risk of developing new GORD symptoms post-surgery and the ability to stop PPI therapy need further investigation, emphasizing the implications for clinical practice.

Limitations:

• Lack of patient-specific data to guide clinical discussions, with examples of how this affects decision-making.
• Potential selection bias in studies included in the review, which may skew results.
• Variability in study designs and quality may affect the reliability of outcomes, warranting caution in interpretation.

Conclusion:

This systematic review highlights the need for more robust data on the impact of RYGB on GORD to inform clinical decision-making and patient counseling, stressing the importance of future research.