Tags

Type your tag names separated by a space and hit enter

Obesity is associated with increased transient lower esophageal sphincter relaxation.
Gastroenterology 2007; 132(3):883-9G

Abstract

BACKGROUND AND AIMS

Obesity has been associated with gastroesophageal reflux disease (GERD) and its complication, but the mechanism is unclear. We evaluated the association between obesity and function of lower esophageal sphincter (LOS) in subjects without GERD.

METHODS

We prospectively recruited consecutive obese (BMI >30) patients referred for weight reduction procedure and age- and sex-matched overweight (BMI 25-30) and normal weight (BMI > or =20 and <25) subjects. Exclusion criteria included esophagitis, reflux symptoms, use of proton pump inhibitor, hiatus hernia >2 cm, and diabetes mellitus with microvascular complication. All participants underwent combined 2-hour postprandial esophageal manometry and pH monitoring after a standard test meal followed by 24-hour ambulatory pH monitoring.

RESULTS

Eighty-four subjects (obese, 28; overweight, 28; normal weight, 28) were studied. All 3 groups had comparable mean LOS pressure, LOS length, and peristaltic function. During the postprandial period, both obese and overweight groups had substantial increase in 2-hour rate of transient lower esophageal sphincter relaxation (TLOSR) (normal weight: 2.1 +/- 1.2 vs overweight: 3.8 +/- 1.6 vs obese: 7.3 +/- 2.0, P < .001), proportion of TLOSR with acid reflux (normal weight: 17.6% +/- 22.0% vs overweight 51.8% +/- 22.5% vs obese: 63.5% +/- 21.7%, P < .001), and gastroesophageal pressure gradient (GOPG) (normal weight: 4.5 +/- 1.2 mm Hg vs overweight: 7.1 +/- 1.4 mm Hg vs obese: 10.0 +/- 1.5 mm Hg, P < .001). Using multiple regression model, BMI (r(2): 0.70, B: 0.28, 95% CI: 0.24-0.33, P < .001) and waist circumference (r(2): 0.65, unstandardized regression coefficient [B]: 0.10, 95% CI: 0.08-0.11, P < .001) were significantly correlated with TLOSR.

CONCLUSIONS

Obesity is associated with increased TLOSR and acid reflux during the postprandial period in subjects without GERD. Abnormal postprandial LOS function may be an early event in the pathogenesis of obesity-related GERD.

Authors+Show Affiliations

Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. justinwu@cuhk.edu.hk

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17324403

Citation

Wu, Justin Che-Yuen, et al. "Obesity Is Associated With Increased Transient Lower Esophageal Sphincter Relaxation." Gastroenterology, vol. 132, no. 3, 2007, pp. 883-9.
Wu JC, Mui LM, Cheung CM, et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132(3):883-9.
Wu, J. C., Mui, L. M., Cheung, C. M., Chan, Y., & Sung, J. J. (2007). Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology, 132(3), pp. 883-9.
Wu JC, et al. Obesity Is Associated With Increased Transient Lower Esophageal Sphincter Relaxation. Gastroenterology. 2007;132(3):883-9. PubMed PMID: 17324403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity is associated with increased transient lower esophageal sphincter relaxation. AU - Wu,Justin Che-Yuen, AU - Mui,Lik-Man, AU - Cheung,Carrian Man-Yuen, AU - Chan,Yawen, AU - Sung,Joseph Jao-Yiu, Y1 - 2006/12/19/ PY - 2006/08/29/received PY - 2006/11/27/accepted PY - 2007/2/28/pubmed PY - 2007/4/27/medline PY - 2007/2/28/entrez SP - 883 EP - 9 JF - Gastroenterology JO - Gastroenterology VL - 132 IS - 3 N2 - BACKGROUND AND AIMS: Obesity has been associated with gastroesophageal reflux disease (GERD) and its complication, but the mechanism is unclear. We evaluated the association between obesity and function of lower esophageal sphincter (LOS) in subjects without GERD. METHODS: We prospectively recruited consecutive obese (BMI >30) patients referred for weight reduction procedure and age- and sex-matched overweight (BMI 25-30) and normal weight (BMI > or =20 and <25) subjects. Exclusion criteria included esophagitis, reflux symptoms, use of proton pump inhibitor, hiatus hernia >2 cm, and diabetes mellitus with microvascular complication. All participants underwent combined 2-hour postprandial esophageal manometry and pH monitoring after a standard test meal followed by 24-hour ambulatory pH monitoring. RESULTS: Eighty-four subjects (obese, 28; overweight, 28; normal weight, 28) were studied. All 3 groups had comparable mean LOS pressure, LOS length, and peristaltic function. During the postprandial period, both obese and overweight groups had substantial increase in 2-hour rate of transient lower esophageal sphincter relaxation (TLOSR) (normal weight: 2.1 +/- 1.2 vs overweight: 3.8 +/- 1.6 vs obese: 7.3 +/- 2.0, P < .001), proportion of TLOSR with acid reflux (normal weight: 17.6% +/- 22.0% vs overweight 51.8% +/- 22.5% vs obese: 63.5% +/- 21.7%, P < .001), and gastroesophageal pressure gradient (GOPG) (normal weight: 4.5 +/- 1.2 mm Hg vs overweight: 7.1 +/- 1.4 mm Hg vs obese: 10.0 +/- 1.5 mm Hg, P < .001). Using multiple regression model, BMI (r(2): 0.70, B: 0.28, 95% CI: 0.24-0.33, P < .001) and waist circumference (r(2): 0.65, unstandardized regression coefficient [B]: 0.10, 95% CI: 0.08-0.11, P < .001) were significantly correlated with TLOSR. CONCLUSIONS: Obesity is associated with increased TLOSR and acid reflux during the postprandial period in subjects without GERD. Abnormal postprandial LOS function may be an early event in the pathogenesis of obesity-related GERD. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/17324403/Obesity_is_associated_with_increased_transient_lower_esophageal_sphincter_relaxation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(06)02682-5 DB - PRIME DP - Unbound Medicine ER -