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Voluntary and controlled weight loss can reduce symptoms and proton pump inhibitor use and dosage in patients with gastroesophageal reflux disease: a comparative study.
Dis Esophagus 2016 Feb-Mar; 29(2):197-204DE

Abstract

A wide variety of pieces of evidence has suggested that obesity is associated with a significant increase in the risk for gastroesophageal reflux disease (GERD) symptoms and its complications. The aim of this study was to evaluate the effect of weight loss on reflux symptoms in overweight/obese patients with proven GERD. We enrolled overweight/obese patients with typical GERD symptoms and erosive esophagitis. At baseline, patients underwent detailed reflux symptoms evaluation and anthropometric assessment, and were divided into two treatment groups: group A received proton pump inhibitor (PPI) and a personalized hypocaloric diet and aerobic exercise; and group B received PPI and a 'standard of care diet'. The dietetic treatment was considered effective if at least 10% of weight loss was achieved within 6 months. All patients were evaluated in terms of anthropometric data, GERD symptoms, and PPI use. In group A, mean body mass index (BMI) decreased from 30.3 ± 4.1 to 25.7 ± 3.1 (P < 0.05), and mean weight decreased from 82.1 ± 16.9 kg to 69.9 ± 14.4 kg (P < 0.05). In group B, there was no change in BMI and weight. Symptom perception decreased (P < 0.05) in both groups during PPI therapy, but a higher improvement was recorded in group A. In group A, PPI therapy was completely discontinued in 27/50 of the patients, and halved in 16/50. Only 7/50 continued the same PPI dosage. In group B, 22/51 halved the therapy and 29/51 maintained full dosage of therapy, but none was able to discontinue PPI due to a symptom recurrence. Overall, weight loss of at least 10% is recommended in all patients with GERD in order to boost the effect of PPI on reflux symptom relief and to reduce chronic medication use.

Authors+Show Affiliations

Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.Gastroenterology and Hepatology Unit, Internal Medicine Department, Assiut University Hospital, Assiut, Egypt.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.Division of Gastroenterology, Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy.Division of Gastroenterology, Department of Translational Research and New Technology in Medicine and Surgery, University of Pisa, Pisa, Italy.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25516110

Citation

de Bortoli, N, et al. "Voluntary and Controlled Weight Loss Can Reduce Symptoms and Proton Pump Inhibitor Use and Dosage in Patients With Gastroesophageal Reflux Disease: a Comparative Study." Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, vol. 29, no. 2, 2016, pp. 197-204.
de Bortoli N, Guidi G, Martinucci I, et al. Voluntary and controlled weight loss can reduce symptoms and proton pump inhibitor use and dosage in patients with gastroesophageal reflux disease: a comparative study. Dis Esophagus. 2016;29(2):197-204.
de Bortoli, N., Guidi, G., Martinucci, I., Savarino, E., Imam, H., Bertani, L., ... Marchi, S. (2016). Voluntary and controlled weight loss can reduce symptoms and proton pump inhibitor use and dosage in patients with gastroesophageal reflux disease: a comparative study. Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, 29(2), pp. 197-204. doi:10.1111/dote.12319.
de Bortoli N, et al. Voluntary and Controlled Weight Loss Can Reduce Symptoms and Proton Pump Inhibitor Use and Dosage in Patients With Gastroesophageal Reflux Disease: a Comparative Study. Dis Esophagus. 2016;29(2):197-204. PubMed PMID: 25516110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voluntary and controlled weight loss can reduce symptoms and proton pump inhibitor use and dosage in patients with gastroesophageal reflux disease: a comparative study. AU - de Bortoli,N, AU - Guidi,G, AU - Martinucci,I, AU - Savarino,E, AU - Imam,H, AU - Bertani,L, AU - Russo,S, AU - Franchi,R, AU - Macchia,L, AU - Furnari,M, AU - Ceccarelli,L, AU - Savarino,V, AU - Marchi,S, Y1 - 2014/12/17/ PY - 2014/12/18/entrez PY - 2014/12/18/pubmed PY - 2016/12/15/medline KW - GERD KW - erosive esophagitis KW - obesity KW - weight loss SP - 197 EP - 204 JF - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus JO - Dis. Esophagus VL - 29 IS - 2 N2 - A wide variety of pieces of evidence has suggested that obesity is associated with a significant increase in the risk for gastroesophageal reflux disease (GERD) symptoms and its complications. The aim of this study was to evaluate the effect of weight loss on reflux symptoms in overweight/obese patients with proven GERD. We enrolled overweight/obese patients with typical GERD symptoms and erosive esophagitis. At baseline, patients underwent detailed reflux symptoms evaluation and anthropometric assessment, and were divided into two treatment groups: group A received proton pump inhibitor (PPI) and a personalized hypocaloric diet and aerobic exercise; and group B received PPI and a 'standard of care diet'. The dietetic treatment was considered effective if at least 10% of weight loss was achieved within 6 months. All patients were evaluated in terms of anthropometric data, GERD symptoms, and PPI use. In group A, mean body mass index (BMI) decreased from 30.3 ± 4.1 to 25.7 ± 3.1 (P < 0.05), and mean weight decreased from 82.1 ± 16.9 kg to 69.9 ± 14.4 kg (P < 0.05). In group B, there was no change in BMI and weight. Symptom perception decreased (P < 0.05) in both groups during PPI therapy, but a higher improvement was recorded in group A. In group A, PPI therapy was completely discontinued in 27/50 of the patients, and halved in 16/50. Only 7/50 continued the same PPI dosage. In group B, 22/51 halved the therapy and 29/51 maintained full dosage of therapy, but none was able to discontinue PPI due to a symptom recurrence. Overall, weight loss of at least 10% is recommended in all patients with GERD in order to boost the effect of PPI on reflux symptom relief and to reduce chronic medication use. SN - 1442-2050 UR - https://www.unboundmedicine.com/medline/citation/25516110/Voluntary_and_controlled_weight_loss_can_reduce_symptoms_and_proton_pump_inhibitor_use_and_dosage_in_patients_with_gastroesophageal_reflux_disease:_a_comparative_study_ L2 - https://academic.oup.com/dote/article-lookup/doi/10.1111/dote.12319 DB - PRIME DP - Unbound Medicine ER -