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Association of obesity with hiatal hernia and esophagitis.
Am J Gastroenterol 1999; 94(10):2840-4AJ

Abstract

OBJECTIVE

Although weight loss is commonly recommended for symptoms of gastroesophageal reflux, a relationship between excessive body weight and esophageal reflux has not been established. The aim of this study was to determine whether obesity is associated with the presence of a hiatal hernia (HH) and/or an endoscopic diagnosis of esophagitis.

METHODS

Retrospective case control studies were done using 1389 patients who underwent gastric analysis and upper GI endoscopy between 1974 and 1995. After excluding patients with Zollinger-Ellison syndrome, 189 cases of esophagitis with 1024 controls were identified. In a separate analysis of the database, 151 cases of HH with 1053 controls were also identified. Patients were classified by body mass index (BMI) as: thin (BMI <20 kg/m2), normal (BMI 20-25), mildly obese (BMI 25-30), and obese (BMI >30).

RESULTS

Excessive body weight was significantly associated with the presence of HH, the probability of HH increasing with each level of BMI (p < 0.01), as well as with esophagitis (OR 1.8; 95% CI 1.4-2.1). HH was independently associated with esophagitis (OR 4.2 95% CI 2.9-6.1); when controlled for the effect of HH, the association between BMI and esophagitis diminished but remained significant. In the population as a whole, for the presence of esophagitis multiple logistic regression indicates BMI and hiatal hernia were significant factors but gender and race did not appear to be.

CONCLUSIONS

Excessive body weight is a significant independent risk factor for hiatal hernia and is significantly associated with esophagitis, largely through an increased incidence of hiatal hernia. Whites are more likely to have the combination of esophagitis and hiatal hernia than are blacks.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 35294-0007, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10520831

Citation

Wilson, L J., et al. "Association of Obesity With Hiatal Hernia and Esophagitis." The American Journal of Gastroenterology, vol. 94, no. 10, 1999, pp. 2840-4.
Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999;94(10):2840-4.
Wilson, L. J., Ma, W., & Hirschowitz, B. I. (1999). Association of obesity with hiatal hernia and esophagitis. The American Journal of Gastroenterology, 94(10), pp. 2840-4.
Wilson LJ, Ma W, Hirschowitz BI. Association of Obesity With Hiatal Hernia and Esophagitis. Am J Gastroenterol. 1999;94(10):2840-4. PubMed PMID: 10520831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of obesity with hiatal hernia and esophagitis. AU - Wilson,L J, AU - Ma,W, AU - Hirschowitz,B I, PY - 1999/10/16/pubmed PY - 1999/10/16/medline PY - 1999/10/16/entrez SP - 2840 EP - 4 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 94 IS - 10 N2 - OBJECTIVE: Although weight loss is commonly recommended for symptoms of gastroesophageal reflux, a relationship between excessive body weight and esophageal reflux has not been established. The aim of this study was to determine whether obesity is associated with the presence of a hiatal hernia (HH) and/or an endoscopic diagnosis of esophagitis. METHODS: Retrospective case control studies were done using 1389 patients who underwent gastric analysis and upper GI endoscopy between 1974 and 1995. After excluding patients with Zollinger-Ellison syndrome, 189 cases of esophagitis with 1024 controls were identified. In a separate analysis of the database, 151 cases of HH with 1053 controls were also identified. Patients were classified by body mass index (BMI) as: thin (BMI <20 kg/m2), normal (BMI 20-25), mildly obese (BMI 25-30), and obese (BMI >30). RESULTS: Excessive body weight was significantly associated with the presence of HH, the probability of HH increasing with each level of BMI (p < 0.01), as well as with esophagitis (OR 1.8; 95% CI 1.4-2.1). HH was independently associated with esophagitis (OR 4.2 95% CI 2.9-6.1); when controlled for the effect of HH, the association between BMI and esophagitis diminished but remained significant. In the population as a whole, for the presence of esophagitis multiple logistic regression indicates BMI and hiatal hernia were significant factors but gender and race did not appear to be. CONCLUSIONS: Excessive body weight is a significant independent risk factor for hiatal hernia and is significantly associated with esophagitis, largely through an increased incidence of hiatal hernia. Whites are more likely to have the combination of esophagitis and hiatal hernia than are blacks. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10520831/Association_of_obesity_with_hiatal_hernia_and_esophagitis_ L2 - http://Insights.ovid.com/pubmed?pmid=10520831 DB - PRIME DP - Unbound Medicine ER -