Purpose: Over the past years, studies have pointed out the connection between the increasing number of people suffering from acid reflux symptoms and the spreading obesity epidemic. More than one-third of U.S. adults (35.7%) are obese (CDC data). In 1998, using the non-adjusted BMI guidelines for Asians, the WHO Global Database on BMI reported overweight and obesity in the Philippines at 23.5%. In 2003, the Philippine National Nutritional Health Evaluation and Survey showed that there are 19.6% overweight and 4.9% obese Filipinos. In the Philippines, the relationship between excessive body weight and GERD is not well established. This study aims to evaluate the relationship of obesity and severity of esophagitis in GERD patients. Methods: Consecutive patients presenting with typical GERD symptoms, i.e., acid regurgitation, heartburn, and/or epigastric pain, were recruited from June 2012 to January 2013. Demographic and clinical data were collected. We used the 2004, WHO new BMI classification intended for Asian population (normal 18.5-22.9 kg/m2, overweight 23-27.4kg/m2, obese I 27.5-32.5 kg/m2, obese II 32.6-37.5 kg/m2). Description of grade of erosive esophagitis (EE) was based on the Los Angeles (LA) Classification, i.e., LA A, LA B and LA C. The prevalence and association of obesity and severity of EE were compared. Results: Of the 445 GERD patients included in this study, patients were classified in Group A, 116 (26%), normal (BMI 22.8+1.3); Group B, 98 (22%), overweight (BMI 24.9+0.2); Group C, 166 (37%) obese I (BMI 27.9 + 1.7); and Group D, 65 (14.6%) obese II (BMI 32.9+0.8). Cross group differences were detected for the severity of EE LA class A, for those with normal BMI is 18%, in overweight is 23%, in obese I is 55% and 59% for obese II (p=0.000). Severity of EE LA class B, normal BMI is 11%, in overweight individuals is 25%, in obese I is 57% and in obese II is 59% (p=0.010). For the severity of EE LA class C, those with normal BMI 1%, in overweight is 28%, in obese I is 55% and for obese II is 54%, p= 0.04). The extents of oesophageal mucosal breaks were more severe in obese patients p=<001. Obesity is a significant risk factor for EE (odds ratio [OR] 2.9, 1.4-2.3; p= <0.001). Conclusion: Obesity is a strong independent risk factor of EE in GERD patients. The severity of EE is much higher in obese patients.
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