Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population.

PURPOSE: With the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older. MATERIALS AND METHODS: A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed. RESULTS: Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m2. After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded. CONCLUSION: According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities.

Helicobacter pylori in metabolic related diseases.

Helicobacter pylori is one of the most common gastrointestinal infection affecting humans worldwide. Hp colonizes the stomach with preferential trophism for the antrum. Hp infection is associated with the development of a chronic gastritis and subsequently with several gastric diseases such as peptic disease, gastric carcinoma and MALT lymphoma. Moreover, Helicobacter pylori infection has also been reported in literature to be associated with many other extra-gastric conditions including sideropenic anemia, thrombocytopenia, neurological, liver and cardiovascular diseases. For some conditions the association is supported by solid literature data and also by the identification of the possible physiopathogenetic mechanism involved. In other cases, the link is only reported by association studies often with conflicting results. In this context, diabetes mellitus, cardiovascular disorders and liver steatosis have all been reported to be associated with Helicobacter pylori infection. Interestingly, these conditions share many characteristics and they often overlap as they represent the expression of the so called metabolic syndrome. Aim of the review was to summarize the available data regarding the association between Helicobacter Pylori infection and diabetes mellitus, cardiovascular disorders and liver steatosis.