Clinical and Endoscopic Characteristics of GERD in Obese Patients

Abstract

Relevance. Obesity and gastroesophageal reflux disease (GERD) – diseases of the XXI century. Obesity is a risk factor for GERD, and has significant negative impact on its course, and causes the ineffectiveness of standard therapeutic approaches. Material and methods. The study involved 1,433 patients treated with proton pump inhibitors (PPIs) for non-erosive reflux disease (NERD) or erosive esophagitis (EE). The observation period was two months and included three visits with a four-week interval. Special attention was paid to the influence of overweight (body mass index (BMI) > 25 kg/m2) and abdominal obesity (waist circumference (WC) in men more than 94 cm, in women − more than 80 cm) on the course of GERD and the effectiveness of acid-suppressive therapy. Results. NERD was diagnosed in 618 (48.1%) patients, EE – in 614 (47.8%) patients. Overweight (BMI > 25 kg/m2) was detected in 901 (62.7%) patients, obesity (BMI > 30 kg/m2) – in 284 (19.9%) patients. Abdominal obesity was detected in 380 (56%) women and 193 (39%) men. Patients with BMI of 25 kg/m2 and abdominal obesity had more pronounced symptoms according to the results of the GERD Q questionnaire. Patients with NERD and EE did not differ in BMI and WC. The effectiveness of PPI therapy by the fourth week did not depend on BMI and WС, but patients without overweight and abdominal obesity were more likely to achieve clinical and endoscopic remission of the disease by the eighth week of therapy. The research participants received rabeprazole therapy in 96% of cases