Study on the relationship between obesity and gastroesophageal reflux disease

Abstract

Objective To investigate the relationship between obesity and esophageal high resolutionmanometry, 24-hour pH monitoring and gastroscopic results of patients with gastroesophageal reflux disease (GERD). Methods A total of 196 patients with GERD(DeMeester score>14.72) were selected and divided into normal weight group (18.5 kg/m2<BMI<24 kg/m2), overweight group (24 kg/m2≤BMI<28 kg/m2) and obese group (BMI≥28 kg/m2) according to body mass index (BMI). Esophageal high resolution manometry, gastroscopy and 24-hour pH monitoring were performed with DeMeester score calculated. The classification of esophagitis was according to Los Angeles standard. Normal distributed measurement data were compared by analysis of variance. Non normal distributed measurement data were repesent as M(P25, P75), and were compared by rank sum test. Chi square test was for count data comparison. Results Compared with normal weight group and overweight group, abdominal length of low esophageal sphincter (LES) of obese group was shorter (1.90 cm, 0.85 cm to 2.45 cm; 2.85 cm, 2.23 cm to 3.20 cm; 2.50 cm, 1.98 cm to 3.0 cm), and the differences were statistically significant (Z=19.913, P 0.05). The percent total time pH≤4 of obesity group was 15.42% (10.31% to 21.49%), percent supine time pH≤4 was 14.21% (5.75% to 34.98%) and percent upright time pH≤4 was 14.25% (8.19% to 18.13%). The reflux episodes (106.50, 67.00 to 145.75) and the longest duration of reflux episodes (28.10 min, 10.90 min to 47.93 min) were more than those of normal group (9.74%, 5.35% to 15.96%; 7.31%, 3.25% to 11.80%; 8.45%, 5.43% to 17.48%; 72.50, 53.00 to 100.50; 15.80 min, 9.90 min to 21.28 min) and overweight group (11.36%, 6.74% to 15.87%; 7.74%, 2.36% to 15.05%; 11.27%, 3.37% to 14.73%; 85.50, 58.75 to 117.75; 21.40 min, 11.50 min to 39.90 min), and the differences were statistically significant (Z=7.054, 11.181, 6.429, 6.452, 8.246, all P 0.05). There was no statistically significant difference in the incidence of Barrett's esophagus among three groups (all P>0.05). Conclusions Compared with that of normal weight group and overweight group of patiento with GERD, abdominal length of LES of obesity group was shorter. With an increase in BMI, acid exposure and the incidences of reflux esophagitis and hiatal hernia also increased. Key words: Gastroesophageal reflux; Esophageal high resolution manometry; BMI; Esophageal pH monitoring; Obesity