Mo1002 Weight Loss Reduces Gastroesophageal Reflux Symptoms: A Prospective Population-Based Cohort Study, the Hunt Study

Abstract

Introduction Heartburn and acid regurgitation are the typical gastroesophageal reflux symptoms (GERS). GERS are associated with reduced health related quality of life, esophagitis, and adenocarcinoma of the esophagus. High body mass index (BMI) is a known risk factor of GERS. However, the effect of weight loss on GERS is not clear. Aims and methods The aim of the study was to clarify the effect of weight loss on GERS. The study was part of a population-based cohort study in Nord-Trondelag County, Norway (the HUNT study), where all adult residents of the county were invited to participate. Between HUNT 2 (19951997) and HUNT 3 (2006-2009) 29610 individuals (61% response rate) were prospectively followed-up, and the participants reported complaints with GERS through written questionnaires at both time points. In addition, a wide range of other health related topics were assessed through questionnaires, and clinical examinations were performed by trained personnel. The risk of losing GERS by decrease in BMI between HUNT 2 and HUNT 3 was calculated by logistic regression. The analyses were stratified by use of antireflux medication (proton pump inhibitors, H2-receptor antagonists, or antacids) and the results were adjusted for sex, age, cigarette smoking status, frequency of alcohol consumption, length of education, and frequency of physical exercise. Results Of the 9299 persons with any GERS (minor or severe complaints) in HUNT 2, 2398 (26%) reported no complaints in HUNT 3, i.e. loss of any GERS. Among those with >3.5 units reduction of BMI, the odds ratio (OR) of loss of any GERS was 1.98 (95% confidence interval (CI) 1.45-2.72; p-value for trend <0.001) compared to those with stable BMI (<0.5 units change) if they used less than weekly antireflux medication or no antireflux medication, and 3.95 (95% CI 2.03-7.65; p-value for trend <0.001) if they used at least weekly antireflux medication (Table). Of the 1553 persons with severe GERS in HUNT 2, 284 (18%) reported no complaints in HUNT 3, i.e. loss of severe GERS, and the respective ORs were 0.90 (95% CI 0.32-2.55; p-value for trend 0.189) and 3.11 (95% CI 1.13-8.58; p-value for trend 0.047; Table). Conclusion Since weight loss seems to reduce GERS dose-dependently and increase the beneficial effect of antireflux medication, it should be considered in the treatment of GERD. Table Odds ratio (OR) and 95% confidence interval (CI) of loss of gastroesophageal reflux symptoms (GERS) by change in body mass index (BMI) and use of antireflux medication, adjusted for sex, age, cigarette smoking, alcohol consumption, education, and physical exercise.