Association of BMI With Heartburn, Regurgitation and Esophagitis
Association of BMI With Heartburn, Regurgitation and Esophagitis
Background: Overweight and obesity are believed to be risk factors for gastroesophageal reflux disease (GERD). The aim of the present study was to analyze the impact of body mass index (BMI) on the severity and frequency of reflux symptoms and esophagitis in a large cohort of reflux patients.
Methods: As part of the Progression of Gastroesophageal Reflux Disease (ProGERD) study, 6215 patients with clinically assessed GERD were included in the present investigation (53% male, 52 ± 14 years; 47% female, 56 ± 14 years). Heartburn and regurgitation symptoms were assessed using the validated Reflux Disease Questionnaire. Endoscopies were performed and patients were subsequently classified as having non-erosive or erosive disease. To examine the association between BMI, GERD symptoms, and esophagitis, odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression models.
Results: In patients with GERD, higher BMI was associated with more frequent and more severe heartburn and regurgitation, as well as with esophagitis. The effects were more pronounced for regurgitation than for heartburn. The strongest association was between obesity and severity of regurgitation symptoms (women: OR 2.11, 95%CI 1.60-2.77; men: OR 2.15, 95%CI 1.59-2.90). Obese women, but not men, had an increased risk of severe esophagitis compared to women with normal weight (OR 2.51, 95%CI 1.53-4.12).
Conclusions: In patients with GERD, higher BMI was associated with more severe and more frequent reflux symptoms and esophagitis.
The symptoms of gastroesophageal reflux disease (GERD) are among the most frequent health problems in Western industrialized societies. Depending on the population studied, the prevalence of heartburn and acid regurgitation ranges from 9% to 42%. A recently published systematic review estimated that the percentage of individuals who experience heartburn or regurgitation on at least a weekly basis varies between 10 and 20%.
During the past several decades, obesity has also emerged as a major health concern in the Western world. Several studies have found an increased risk of esophagitis in overweight patients. One recent population-based case-control study reported a strong association between body mass index (BMI) and esophagitis in women, but not in men.
Studies on the association between BMI and GERD symptoms have yielded inconsistent results. A population-based study in Sweden found no link between BMI and reflux symptoms. In a birth cohort from New Zealand, overweight and obesity were not associated with reflux symptoms in young adults. However, in the larger population-based studies conducted to date, overweight and obesity have been shown to be risk factors for reflux symptoms. One study found a more pronounced association in women than in men.
The aim of the present study was to analyze the association of BMI with severity and frequency of reflux symptoms and esophagitis in a large cohort of GERD patients.
Background: Overweight and obesity are believed to be risk factors for gastroesophageal reflux disease (GERD). The aim of the present study was to analyze the impact of body mass index (BMI) on the severity and frequency of reflux symptoms and esophagitis in a large cohort of reflux patients.
Methods: As part of the Progression of Gastroesophageal Reflux Disease (ProGERD) study, 6215 patients with clinically assessed GERD were included in the present investigation (53% male, 52 ± 14 years; 47% female, 56 ± 14 years). Heartburn and regurgitation symptoms were assessed using the validated Reflux Disease Questionnaire. Endoscopies were performed and patients were subsequently classified as having non-erosive or erosive disease. To examine the association between BMI, GERD symptoms, and esophagitis, odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression models.
Results: In patients with GERD, higher BMI was associated with more frequent and more severe heartburn and regurgitation, as well as with esophagitis. The effects were more pronounced for regurgitation than for heartburn. The strongest association was between obesity and severity of regurgitation symptoms (women: OR 2.11, 95%CI 1.60-2.77; men: OR 2.15, 95%CI 1.59-2.90). Obese women, but not men, had an increased risk of severe esophagitis compared to women with normal weight (OR 2.51, 95%CI 1.53-4.12).
Conclusions: In patients with GERD, higher BMI was associated with more severe and more frequent reflux symptoms and esophagitis.
The symptoms of gastroesophageal reflux disease (GERD) are among the most frequent health problems in Western industrialized societies. Depending on the population studied, the prevalence of heartburn and acid regurgitation ranges from 9% to 42%. A recently published systematic review estimated that the percentage of individuals who experience heartburn or regurgitation on at least a weekly basis varies between 10 and 20%.
During the past several decades, obesity has also emerged as a major health concern in the Western world. Several studies have found an increased risk of esophagitis in overweight patients. One recent population-based case-control study reported a strong association between body mass index (BMI) and esophagitis in women, but not in men.
Studies on the association between BMI and GERD symptoms have yielded inconsistent results. A population-based study in Sweden found no link between BMI and reflux symptoms. In a birth cohort from New Zealand, overweight and obesity were not associated with reflux symptoms in young adults. However, in the larger population-based studies conducted to date, overweight and obesity have been shown to be risk factors for reflux symptoms. One study found a more pronounced association in women than in men.
The aim of the present study was to analyze the association of BMI with severity and frequency of reflux symptoms and esophagitis in a large cohort of GERD patients.
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