The epidemic of morbid obesity in the United States has reached dramatic proportions. Because of the associated comorbidities and because life style changes and exercise have limited effect, bariatric surgery has been used more often during the last 10 years as it has been shown to be safe and effective in decreasing weight and resolving comorbidities. Recently many studies have focused on a potential complication of bariatric surgery, gastroesophageal reflux disease, mostly because of the increasing use of sleeve gastrectomy. This article reviews the pathophysiology of reflux in morbid obese patients, the proper work-up before a bariatric operation, and the selection of the procedure based on the individual patient's characteristics.
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