Effect of Continuous Positive Airway Pressure (CPAP) on Lower Esophageal Sphincter Pressure in Morbidly Obese Patients

Effect of Continuous Positive Airway Pressure On Lower Esophageal Sphincter Pressure in Subjects Undergoing Bariatric Surgery

This trial is enrolling patients who are already being seen at OHSU weight loss clinic or have been referred for clinical reasons by their physician to the OHSU weight loss clinic and are going to have a esophageal manometry that would be paid for by their insurance company for clinical reasons.

In patients undergoing weight loss surgery investigators plan to study the effect of continuous positive airway pressure during a esophageal manometry.

Study Overview

• Status: Completed
• Conditions: Sleep Apnea; Gastroesophageal Reflux Disease

Detailed Description

Subjects will be invited to be in this research study because they are being considered for weight loss (bariatric) surgery that is being paid for by their insurance company. As part of the preparation for surgery, subjects will have a test called manometry that measures pressure in the esophagus (food pipe). For this test, a tube will be lowered down one nostril into the food pipe.

Studies have shown that Continuous Positive Airway Pressure (CPAP) reduces reflux in people with or without sleep apnea as well as in people with reflux. The investigators are trying to understand how this occurs. This research study will add about 10 additional minutes to the clinic visit. The investigators expect about 50 subjects to be in the study at OHSU. Outcomes will be measured at 18 months.

Patients scheduled for esophageal manometry and motility studies prior to their bariatric surgery will be given a study flyer at the bariatric clinic. A list of the patients who are interested in participating in the study will be given to one of the study investigators. A study investigator will call these patients to explain the study, assess their interest in participation, and review their eligibility for entrance into the study. Assessment of eligibility will be done by asking for medical history over the phone as well as by requesting access to their medical record to ensure the patients do not meet exclusion criteria. After review of the patient's clinical history verbally and through review of the medical record, informed consent will be signed at their manometry appointment.

Subjects will undergo the manometry procedure. After finishing the procedure, when the catheter would normally be withdrawn after the procedure, it will remain in place for the study. A CPAP mask will be placed over the subject's nose. CPAP blows air in the nose with a mild pressure. The air pressure will be slowly increased while pressure in the esophagus is being recorded. As done with the regular manometry, the subject will be asked to swallow small amounts of water during the test. The test will be completed in 10 minutes. The CPAP and the tube will be removed.

Subjects will complete a questionnaire prior to the manometry about gastrointestinal symptoms.

• Study Type: Observational
• Enrollment (Actual): 20

Contacts and Locations

Study Locations

• United States
  • Oregon
    • Portland, Oregon, United States, 97239
      • Oregon Health & Science University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 76 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Adult Patients

Description

Inclusion Criteria

1. Adult > 18 yrs old
2. Willing to give informed consent
3. Undergoing bariatric surgery and scheduled to undergo manometry and polysomnography as part of the protocol.

Exclusion Criteria

1. Patient unwilling to give informed consent
2. Pregnant women
3. Patients with prior history of esophageal surgery (e.g. Nissen fundoplication, partial resection, dilation, stent placement), known anatomic abnormality of the esophagus (e.g. stricture, Schatzki's ring, Zenker's diverticulum, malignancy, varices, ulcers), and/or known functional abnormality of the esophagus (e.g. achalasia, dysmotility).

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
CPAP, Manometry; Patients undergoing Manometry before weight loss surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower Esophageal Sphincter Pressure	Effect of CPAP on Lower esophageal sphincter pressure will be assessed after 18 months of data collection or after all 50 patients have been assessed	18 months

Collaborators and Investigators

• Sponsor: Oregon Health and Science University

Publications and helpful links

Helpful Links

• OHSU Pulmonary Critical Care Medicine

Study record dates

Study Major Dates

• Study Start: January 1, 2010
• Primary Completion (Actual): December 1, 2011
• Study Completion (Actual): June 1, 2012

Study Registration Dates

• First Submitted: January 14, 2010
• First Submitted That Met QC Criteria: April 6, 2010
• First Posted (Estimate): April 7, 2010

Study Record Updates

• Last Update Posted (Actual): August 30, 2019
• Last Update Submitted That Met QC Criteria: August 27, 2019
• Last Verified: August 1, 2019

More Information

Terms related to this study

• Keywords: GERD; Sleep Apnea; Bariatric Surgery; Gastroesophageal Reflux Disease
• Additional Relevant MeSH Terms: Digestive System Diseases; Nervous System Diseases; Respiratory Tract Diseases; Apnea; Respiration Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Gastrointestinal Diseases; Esophageal Motility Disorders; Deglutition Disorders; Esophageal Diseases; Sleep Apnea Syndromes; Gastroesophageal Reflux
• Other Study ID Numbers: IRB00005565