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Added confounding influences are Barretts metaplasia that makes it more difficult to ascertain the location of the native SCJ, an extremely patulous hiatus that makes it difficult to precisely localize the crural diaphragm, and excess insufflation of the stomach that might exaggerate the apparent size of the hernia

Blood samples for glucose were drawn at 0 and 120 min of OGTT

Support a healthy gut microbiome , which plays an important role in overall metabolic health

Temporary in first weeks from calorie deficit

Functional (primary) constipation is thought to involve gut-brain axis dysfunction (De Palma 2014)