Gastrointestinal symptoms in morbid obesity.

Mustafa Huseini,Glenn S Gerhard,David D K Rolston,Jamie Seiler,G Craig Wood,George Argyropoulos,Brian A Irving,Christopher Still,Peter Benotti

doi:10.3389/fmed.2014.00049

Abstract

Background: Several reports have shown an increased prevalence of gastrointestinal (GI) symptoms in obese subjects in community-based studies. To better understand the role of the GI tract in obesity, and because there are limited clinic-based studies, we documented the prevalence of upper and lower GI symptoms in morbidly obese individuals in a clinic setting.Objective: The aim of our study was to compare the prevalence of GI symptoms in morbidly obese individuals in a weight management clinic with non-obese individuals with similar comorbidities as morbidly obese individuals in an Internal Medicine clinic.Methods: Class II and III obese patients BMI >35 kg/m2 (N = 114) and 182 non-obese patients (BMI <25 kg/m2) completed the GI symptoms survey between August 2011 and April 2012 were included in this study. The survey included 24 items pertaining to upper and lower GI symptoms. The participants rated the frequency of symptoms as absent (never, rarely) or present (occasionally, frequently). The symptoms were clustered into five categories: oral symptoms, dysphagia, gastroesophageal reflux, abdominal pain, and bowel habits. Responses to each symptom cluster were compared between obese group and normal weight groups using logistic regression.Results: Of the 24 items, 18 had a higher frequency in the obese group (p < 0.005 for each). After adjusting for age and gender, the obese patients were more likely to have upper GI symptoms: any oral symptom (OR = 2.3, p = 0.0013), dysphagia (OR 2.9, p = 0.0006), and any gastroesophageal reflux (OR 3.8, p < 0.0001). Similarly, the obese patients were more likely to have lower GI symptoms: any abdominal pain (OR = 1.7, p = 0.042) and altered bowel habits (OR = 2.8, p < 0.0001).Conclusion: These observations suggest a statistically significant increase in frequency of both upper and lower GI symptoms in morbidly obese patients when compared to non-obese subjects.

Highlights

The obese patients were more likely to have lower GI symptoms: any abdominal pain (OR = 1.7, p = 0.042) and altered bowel habits (OR = 2.8, p < 0.0001). These observations suggest a statistically significant increase in frequency of both upper and lower GI symptoms in morbidly obese patients when compared to non-obese subjects
The 182 normal weight patients had a mean BMI of 22.1 kg/m2 (SD = 1.7), a mean age of 50.8 years (SD = 11.1), and 78% were female (Table 2)
As compared to the 470 non-responders, the normal weight patients that responded to the survey were older (50.8 years versus 45.0 years, p < 0.0001) and more likely to be female (78 versus 70% female, p = 0.040)

Summary

Introduction

The increasing prevalence of overweight and obesity has resulted in. 3.4 million deaths, 3.9% of years lost, and 3.8% of disability adjusted life-years world-wide. Greater than 50% of obese individuals reside in the USA, China, India, Russia, Brazil, Egypt, Germany, Pakistan, and Indonesia [1]. 13% of these obese individuals in 2013. Obesity trends in the USA along with associated comorbidities could, for the first time result in decreased life expectancy [2]. Several reports have shown an increased prevalence of gastrointestinal (GI). Symptoms in obese subjects in community-based studies. To better understand the role of the GI tract in obesity, and because there are limited clinic-based studies, we documented the prevalence of upper and lower GI symptoms in morbidly obese individuals in a clinic setting

Methods

Results

Conclusion