Pellegrini, obesity and

[Guest guest]

Dear Jeanie,

I found part of this one article co-written by Dr. Pellegrini

addressing the issue. Again he states obesity is not associated w/

achalasia. He has lots of articles in pubmed. I really don't know

the % of us with weight issues, if it is above or below the normal

%. It seems like a LOT of us DO have issues w/ weight, before and

after surgery, so I don't like his comment. He is VERY published,

especially regarding SCARS (is that right?) I read a lot of his

articles just before my surgery and afterward. Just for me, this

obesity issue he has, which I had forgotten, gave me the impression

that he made judgements w/o really looking at the data. But again, I

have NO way to judge surgeons, don't know enough to do so. I know he

is more convenient for you, but you are extra special, both

physically and emotionally, and geographically. I noticed many

support groups for weight loss surgery, maybe read some of those.

Maybe some have really bad GERD, and you can find out what happened

after surgery. GERD happens when the sphincter doesn't shut well and

maybe those people can discuss if food backed up into their

esophagus. Just remember your esophagus won't be pushing it back

down.

I'm sure you know people w/ gastric bypass surgery, same as all of

us. Maybe you can discuss it more with them? I'll send 's

phone number to you. I spoke w/ her several months ago and she was

still doing reasonably well, but eating was an issue in her life, and

her larger concern really was gaining back the weight she had loss

and all the increased health issues caused by extra weight.

There are no good answers.

Sandy

Please Note: Performing your original search, [all: achalasia gastric

bypass], in Ann Liebert will retrieve 14 citations .

Journal of Laparoendoscopic & Advanced Surgical Techniques

Laparoscopic Heller Myotomy and Roux-en-Y Gastric Bypass: A Novel

Operation for the Obese Patient with Achalasia

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To cite this paper:

Jedediah A. Kaufman, A. Pellegrini, Brant K. Oelschlager.

Journal of Laparoendoscopic & Advanced Surgical Techniques. August 1,

2005, 15(4): 391-395. doi:10.1089/lap.2005.15.391.

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Full Text PDF: • HiRes for printing (81.5 KB) • PDF Plus w/ links

(104.2 KB)

Jedediah A. Kaufman, MD

Department of Surgery, University of Washington, Seattle, Washington.

A. Pellegrini, MD

Department of Surgery, University of Washington, Seattle, Washington.

Brant K. Oelschlager, MD

Department of Surgery, University of Washington, Seattle, Washington.

Morbid obesity is a disease encompassing multiple, significant

comorbidities. The only current, reliable, durable treatment of

obesity is surgical intervention, most commonly gastric bypass.

Achalasia, a swallowing disorder of esophageal motility and failure

of the lower esophageal sphincter (LES) to relax, is rarely seen in

the morbidly obese patient. Treatment is directed at disruption of

the LES to allow passage of food. As medical management usually fails

in both disease processes, surgical treatment is often chosen. The

patient with both morbid obesity and achalasia presents an unusual

challenge for surgical treatment. The standard surgical approach for

each disease does not address the other, and may have deleterious

consequences on the other condition if approached unilaterally. We

present the first case of a patient treated with a concomitant

laparoscopic esophagogastric myotomy (LEM) and laparoscopic Roux-en-Y

gastric bypass (LRYGBP).

This paper was cited by:

Simultaneous Surgical Management of Achalasia and Morbid Obesity

W. O?Rourke, Blair A. Jobe, Donn H. Spight, G. Hunter

Obesity Surgery. 2007, Vol. 17, No. 4: 547

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