Obesity influences esophageal function in GERD

A study published ahead of print in Alimentary Pharmacology & Therapeutics examines the effects of obesity on esophageal function, acid exposure and the symptoms of gastro-esophageal reflux disease.

Obese patients have an increased risk of gastro-esophageal reflux disease; however, the mechanism underlying this association is uncertain.

Dr Anggiansah and colleagues examined the mechanical effects of obesity on esophageal function increase acid exposure and symptoms.

The team measured that height, weight and waist circumference in patients with typical reflux symptoms referred for manometry and 24 h ambulatory pH studies.

Symptom severity was assessed by questionnaire.

The research team evaluated the association between obesity, esophageal function, acid exposure and reflux symptoms was assessed.

Physiological measurements were obtained from 582 patients of whom 406 completed symptom questionnaires.

The team of doctors found that the prevalence of general obesity was greater in women, however more men had abdominal obesity.

Reflux symptoms increased with acid exposure

Alimentary Pharmacology & Therapeutics

The team noted that esophageal acid exposure increased with obesity, and was associated also with lower esophageal sphincter pressure, reduced abdominal lower esophageal sphincter length and peristaltic dysfunction.

The researchers showed a negative association with both lower esophageal sphincter pressure, and abdominal lower esophageal sphincter length.

However, multivariable analysis demonstrated that the effects of increasing waist circumference on esophageal function do not explain increased acid reflux in obese patients.

The team of doctors identified independent effects of obesity and esophageal dysfunction on acid exposure.

Reflux symptoms increased with acid exposure and this association explained increased symptom severity in obese patients.

Dr Anggiansah's team concluded, "Abdominal obesity is associated with esophageal dysfunction, increased acid exposure and reflux symptoms."

"However, this analysis does not support the mechanical hypothesis that the effects of obesity on esophageal function are the cause of increased acid exposure in obese patients."