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 22 January 2018

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News

Gastroesophageal reflux in obese subjects

Obesity predisposes patients to gastroesophageal reflux, while body weight loss, particularly visceral fat loss, results in improved reflux parameters, find researchers in the November issue of the Scandinavian Journal of Gastroenterology.

News image

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Gastroesophageal reflux is an obesity-related health risk, which is assumed to improve after weight loss. However, prolonged intragastric balloon distension may oppose this.

In this study, researchers from the Netherlands investigated the prevalence of gastroesophageal reflux in untreated obese subjects.

In addition, they studied the consequences of weight loss with or without intragastric balloon treatment.

The research team randomized patients in a double-blind, sham-controlled trial, to receive either balloon or sham treatment for 13 weeks.

Following this all subjects received a balloon for the remaining year.

The team performed 24-hour pH recordings at the start of the study, after 13 weeks of balloon or sham treatment, after 26 and 52 weeks of balloon treatment, and 13 weeks after balloon removal.

The pH data of the 42 untreated patients (BMI 43.4 kg/m2) were highly abnormal.

The team found that 52% had some evidence of reflux, 40% showed pathological total reflux times, and 19% had combined total, upright and supine reflux, with grade B reflux esophagitis in only 1 patient.

Albeit poorly, esophageal acid exposure was related to body weight and visceral fat distribution.

The researchers observed a reduction in acid reflux in sham-treated weight-losing subjects, whereas in balloon-treated subjects supine reflux and duration of the longest reflux increased.

Furthermore, in the second 13-week period, the initially improved pH values worsened by balloon placement in sham-treated subjects.

However, values in balloon-balloon-treated subjects stabilized.

In balloon-treated subjects supine reflux and duration of the longest reflux increased.
Scandinavian Journal of Gastroenterology
After 52 weeks, acid reflux leveled off at pretreatment values and further improved after balloon removal.

At these times, decreased visceral fat masses correlated significantly with diminished esophageal exposure to acid.

Professors Mathus-Vliegen and Tytgat concluded, "Obesity predisposed to gastro-esophageal reflux".

"Body weight loss and, strikingly, visceral fat loss resulted in improved reflux parameters".

"Adverse effects on acid reflux by gastric balloon distension wore off over time".

Scand J Gastroenterol 2002; 37(11): 1246-52
26 November 2002

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