The effects of obesity on oesophageal function, acid exposure and the symptoms of gastro‐oesophageal reflux disease

Anggiansah, Roy; Sweis, Rami; Anggiansah, Angela; Wong, Terry; Cooper, Derek; Fox, Mark

doi:10.1111/apt.12208

Cited by 66 publications

(50 citation statements)

References 36 publications

(68 reference statements)

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“…However, there seems to be other mechanisms contributing to this association, including reduced lower esophageal sphincter pressure in obese individuals [75], [76]. In any case, esophageal acid exposure has been positively associated with BMI [75] and waist circumference [76], [77].…”

Section: Discussionmentioning

confidence: 96%

Determinants of Gastroesophageal Reflux Disease, Including Hookah Smoking and Opium Use– A Cross-Sectional Analysis of 50,000 Individuals

et al. 2014

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BackgroundGastroesophageal reflux disease (GERD) is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time.MethodsWe performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn.ResultsApproximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02–1.75) and opium use (OR 1.70, 95% CI 1.55–1.87) were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76–0.99). After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined).ConclusionGERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere.

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Section: Discussionmentioning

confidence: 96%

Determinants of Gastroesophageal Reflux Disease, Including Hookah Smoking and Opium Use– A Cross-Sectional Analysis of 50,000 Individuals

et al. 2014

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“…In addition, other factors combine to predispose to gastroesophageal reflux and its complications, including a reduced length of the intra-abdominal portion of the lower esophageal sphincter and peristaltic dysfunction of the esophagus. 7,8 Obesity also results in increased esophageal acid exposure, 8,9 and this may be related in part to increased estrogen levels, which are higher in obesity than in lean age- and sex-matched controls and are associated strongly with increased acid exposure and gastroesophageal reflux disease (GERD). 10–12 These alterations in functions can result in regurgitation, esophagitis, and GERD, which may progress to Barrett’s esophagus and esophageal adenocarcinoma.…”

Section: Esophagusmentioning

confidence: 99%

Gastrointestinal Complications of Obesity

2017

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Obesity usually is associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease, erosive esophagitis, Barrett’s esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer. Gastroenterologists are uniquely poised to participate in the multidisciplinary management of obesity as physicians caring for people with obesity-related diseases, in addition to their expertise in nutrition and endoscopic interventions.

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“…This is believed to be a mechanism behind the higher rates of gastroesophageal reflux in obese individuals (23,28,29). This could lead to a higher rate of aspiration in these patients and work synergistically with OSA.…”

Section: Original Researchmentioning

confidence: 99%