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[Higher prevalence of obesity in erosive gastroesophageal reflux disease].

Abstract

CONTEXT

Weight loss is commonly recommended as a treatment for gastroesophageal reflux; however, a relationship between excessive body weight and gastroesophageal reflux disease is not well established.

OBJECTIVES

To evaluate the prevalence of obesity and over-weight in patients with heartburn, with and without erosive esophagitis; to analyze the prevalence of hiatal hernia and the intensity of abnormal gastroesophageal reflux in both groups of patients, and its relation to body mass index.

METHODS

The data of pH monitoring of 362 individuals with heartburn were evaluated retrospectively. All patients had an upper gastrointestinal endoscopy and erosive esophagitis was defined by the presence of macroscopic erosion on the esophageal mucosa. Hiatal hernia was considered when the gastroesophageal junction was positioned 2 cm or more above the diaphragm. Patients with Barrett's esophagus or esophageal peptic stenosis were excluded. The population was categorized according to body mass index as normal weight (body mass index between 20 and 24.9); over-weight (between 25 and 29.9), and obese (greater than 30). The diagnosis as well as the intensity of abnormal gastroesophageal reflux were obtained through the analysis of the results of pH monitoring in patients with and without erosive esophagitis and in the various categories of body mass index.

RESULTS

Among the 362 patients there were 148 (41%) with erosive esophagitis and 214 (59%) without erosive esophagitis, while the pH monitoring was abnormal in 100% and 57%, respectively. Among the 148 individuals with erosive esophagitis (61% male, median age 50 years), 41 (28%) had normal weight, 82 (55%) had over-weight and 25 (17%) were obese. There were 88 (60%) patients with hiatal hernia, which was present in 29 (71% of patients with normal weight), 45 (55% of patients with over-weight) and 14 (56% of obese individuals). In 121 patients without erosive esophagitis who had abnormal pH monitoring, diagnosed as non erosive reflux disease (38% male, median age 50 years), 51 (42%) patients had normal weight, 55 (46%) had over-weight and 15 (12%) were obese. Hiatal hernia was detected in 52 out of 121 (43%) patients and in 21 (41%) out of 51 individuals with normal weight, 24 (44%) of over-weight and 7 (47%) of obese. In the group of 93 patients without erosive esophagitis and normal pH monitoring (29% male, median age 43 years), 26 (28%) had hiatal hernia and there were 43 (46%) individuals with normal weight, 38 (41%) with over-weight and 12 (13%) were obese. The number of patients with obesity and over-weight was significantly higher in the group with erosive esophagitis compared to the ones without erosive esophagitis. The prevalence of hiatal hernia was also superior in the erosive reflux disease patients. The reflux intensity and the prevalence of hiatal hernia were similar in patients with normal weight, over-weight and obesity in the group with erosive reflux disease and non-erosive reflux disease.

CONCLUSION

There was a greater prevalence of obesity and over-weight in the group of patients with erosive esophagitis compared to patients with non-erosive reflux disease. There was no difference in reflux intensity measurements in any of the body mass index categories, in both groups. Although there was a major prevalence of hiatal hernia in the group of erosive reflux disease patients, this superiority was not extended to the categories of excessive weight in both groups.

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  • Authors+Show Affiliations

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    Serviço de Gastroenterologia do HUCFF-UFRJ, Rio de Janeiro, RJ. biabiccas@gmail.com

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    MeSH

    Adolescent
    Adult
    Aged
    Body Mass Index
    Brazil
    Epidemiologic Methods
    Esophagitis, Peptic
    Female
    Gastroesophageal Reflux
    Heartburn
    Hernia, Hiatal
    Humans
    Male
    Middle Aged
    Obesity
    Severity of Illness Index
    Young Adult

    Pub Type(s)

    English Abstract
    Journal Article

    Language

    por

    PubMed ID

    19466304

    Citation

    Biccas, Beatriz N., et al. "[Higher Prevalence of Obesity in Erosive Gastroesophageal Reflux Disease]." Arquivos De Gastroenterologia, vol. 46, no. 1, 2009, pp. 15-9.
    Biccas BN, Lemme EM, Abrahão LJ, et al. [Higher prevalence of obesity in erosive gastroesophageal reflux disease]. Arq Gastroenterol. 2009;46(1):15-9.
    Biccas, B. N., Lemme, E. M., Abrahão, L. J., Aguero, G. C., Alvariz, A., & Schechter, R. B. (2009). [Higher prevalence of obesity in erosive gastroesophageal reflux disease]. Arquivos De Gastroenterologia, 46(1), pp. 15-9.
    Biccas BN, et al. [Higher Prevalence of Obesity in Erosive Gastroesophageal Reflux Disease]. Arq Gastroenterol. 2009;46(1):15-9. PubMed PMID: 19466304.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Higher prevalence of obesity in erosive gastroesophageal reflux disease]. AU - Biccas,Beatriz N, AU - Lemme,Eponina Maria Oliveira, AU - Abrahão,Luiz J,Jr AU - Aguero,Gustavo Cálcena, AU - Alvariz,Angela, AU - Schechter,Rosana Bihari, PY - 2008/02/21/received PY - 2008/04/10/accepted PY - 2009/5/26/entrez PY - 2009/5/26/pubmed PY - 2009/10/16/medline SP - 15 EP - 9 JF - Arquivos de gastroenterologia JO - Arq Gastroenterol VL - 46 IS - 1 N2 - CONTEXT: Weight loss is commonly recommended as a treatment for gastroesophageal reflux; however, a relationship between excessive body weight and gastroesophageal reflux disease is not well established. OBJECTIVES: To evaluate the prevalence of obesity and over-weight in patients with heartburn, with and without erosive esophagitis; to analyze the prevalence of hiatal hernia and the intensity of abnormal gastroesophageal reflux in both groups of patients, and its relation to body mass index. METHODS: The data of pH monitoring of 362 individuals with heartburn were evaluated retrospectively. All patients had an upper gastrointestinal endoscopy and erosive esophagitis was defined by the presence of macroscopic erosion on the esophageal mucosa. Hiatal hernia was considered when the gastroesophageal junction was positioned 2 cm or more above the diaphragm. Patients with Barrett's esophagus or esophageal peptic stenosis were excluded. The population was categorized according to body mass index as normal weight (body mass index between 20 and 24.9); over-weight (between 25 and 29.9), and obese (greater than 30). The diagnosis as well as the intensity of abnormal gastroesophageal reflux were obtained through the analysis of the results of pH monitoring in patients with and without erosive esophagitis and in the various categories of body mass index. RESULTS: Among the 362 patients there were 148 (41%) with erosive esophagitis and 214 (59%) without erosive esophagitis, while the pH monitoring was abnormal in 100% and 57%, respectively. Among the 148 individuals with erosive esophagitis (61% male, median age 50 years), 41 (28%) had normal weight, 82 (55%) had over-weight and 25 (17%) were obese. There were 88 (60%) patients with hiatal hernia, which was present in 29 (71% of patients with normal weight), 45 (55% of patients with over-weight) and 14 (56% of obese individuals). In 121 patients without erosive esophagitis who had abnormal pH monitoring, diagnosed as non erosive reflux disease (38% male, median age 50 years), 51 (42%) patients had normal weight, 55 (46%) had over-weight and 15 (12%) were obese. Hiatal hernia was detected in 52 out of 121 (43%) patients and in 21 (41%) out of 51 individuals with normal weight, 24 (44%) of over-weight and 7 (47%) of obese. In the group of 93 patients without erosive esophagitis and normal pH monitoring (29% male, median age 43 years), 26 (28%) had hiatal hernia and there were 43 (46%) individuals with normal weight, 38 (41%) with over-weight and 12 (13%) were obese. The number of patients with obesity and over-weight was significantly higher in the group with erosive esophagitis compared to the ones without erosive esophagitis. The prevalence of hiatal hernia was also superior in the erosive reflux disease patients. The reflux intensity and the prevalence of hiatal hernia were similar in patients with normal weight, over-weight and obesity in the group with erosive reflux disease and non-erosive reflux disease. CONCLUSION: There was a greater prevalence of obesity and over-weight in the group of patients with erosive esophagitis compared to patients with non-erosive reflux disease. There was no difference in reflux intensity measurements in any of the body mass index categories, in both groups. Although there was a major prevalence of hiatal hernia in the group of erosive reflux disease patients, this superiority was not extended to the categories of excessive weight in both groups. SN - 1678-4219 UR - https://www.unboundmedicine.com/medline/citation/19466304/[Higher_prevalence_of_obesity_in_erosive_gastroesophageal_reflux_disease]_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032009000100008&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -