medigraphic.com
Asociación Mexicana de Gastroenterología

2007, Number 3

<< Back Next >>

Rev Gastroenterol Mex 2007; 72 (3)

Obesity, symptoms of gastroesophageal reflux and endoscopic findings in a referral hospital

Peralta-Torres NM, Trujillo-Benavides OE, Paredes-Cruz E, Méndez-del Monte R, Baltazar-Montúfar PJ

Language: Spanish
References: 35
Page: 214-221
PDF size: 70.17 Kb.


ABSTRACT

Objective: To determine association between obesity, gastroesophageal reflux symptoms, hiatus hernia and erosive esophagitis. Methods: Consecutive patients who underwent upper endoscopies at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire. Weight and height of all patients were determined. Body mass index was calculated. At endoscopy it was looked for the presence of hiatus hernia and erosive esofagitis. We excluded patients with some of the following conditions: Pregnancy, ascitis, esophageal varices, esophageal, gastric or duodenal stenosis, and patient who required an emergency or therapeutic endoscopy. We compared prevalence of symptomatic GERD, hiatus hernia and erosive esophagitis between normal weight patients, overweight and obese. Results: A total of 196 patients were included for analysis, 122 women and 74 men, mean age 52.5 years, 40.3% were overweight and 28.1% were obese. There were 124 patients (63.3%) with symptoms of GERD determined by the C-D Questionnaire obtained. Hiatus hernia was observed in 87 patients (44.4%), and erosive esophagitis in 69 patients (35.7%). Prevalence of GERD symptoms in obese or overweight patients were similar to those normal-weight patients (66.4% and 56.5% respectively, p = 0.20) OR 1.52 (IC 95%, 0.82-2.82). Among obese or overweight hiatus hernia was observed in 47% compared to 38.7% of those normal-weight (p = 0.28) OR 1.40 (IC 95%, 0.76-2.59). Prevalence of erosive esofagitis was also similar in both groups 37.3% and 32.3% respectively (p = 0.52) OR 1.25 (IC 95%, 0.66-2.36). Conclusions: This study didn’t show association between symptoms of GERD, hiatus hernia or erosive esofagitis and overweight or obesity.


REFERENCES

  1. El-Serag HB. Obesity and disease of the esophagus and colon. Gastroenterol Clin N Am 2005; 34: 63-82.

  2. Encuesta Nacional de Nutrición II. Secretaría de Salud. Instituto Nacional de Salud Pública. México: 1999.

  3. Olaiz G, Rojas R, Barquera S, Shamah T, Aguilar C, et al. Encuesta Nacional de Salud 2000. Tomo 2. La salud de los adultos. Cuernavaca, Morelos, México: Instituto Nacional de Salud Pública; 2003. (www.insp.mx/ensa2000)

  4. Locke GR, Talley NJ, Fett SL, et al. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997; 112: 1448-56.

  5. Dent J, El-Serag HB, Wallander MA, Johanson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005; 54: 710-17.

  6. Trujillo-Benavides OE, Castillo-Barradas M, García-Juárez J, et al. Prevalencia y perfil clínico de la enfermedad por reflujo gastroesofágico en una población abierta. Rev Gastroenterol Mex 2003; 68(Supl. 3): 123.

  7. Sugerman HJ, DeMaria EJ, Felton WL III, et al. Increased intra-abdominal pressure and cardiac filling pressure in obesity-associated pseudotumor cerebri. Neurology 1997; 49: 507-11.

  8. Maddox A, Horowitz M, Wishart J, et al. Gastric and oesophageal emptying in obesity. Scand J Gastroenterol 1989; 24: 593-8.

  9. Mercer CD, Wren SF, DaCosta LR, et al. Lower esophageal sphincter pressure and gastroesophageal pressure gradients in excessively obese patients. J Med 1987; 18: 135-46.

  10. O’Brien TF Jr. Lower esophageal sphincter pressure (LESP) and esophageal function in obese humans. J Clin Gastroenterol 1980; 2: 145-8.

  11. Mathus-Viegen EMH, van Weeren M, Van Eerten PV. LOS function and obesity: the impact of untreated obesity weight loss, and chronic gastric balloon distension. Digestion 2003; 68: 161-8.

  12. Kjellin A, Ramel S, Rossner S, et al. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol 1996; 31: 1047-51.

  13. Wilson LJ, MA W, Hirschowitz B. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol 1999; 94: 2840-4.

  14. El-Serag HB, Johanson JF. Risk factors for the severity of erosive esophagitis in Helicobacter pylori-negative patients with gastroesophageal reflux disease. Scand J Gastroenterol 2002: 899-904.

  15. Labenz J, Jasperson D, Kulig M, et al. Risk factors for erosive esophagitis a multi-variate analysis based on the ProGERD study initiative. Am J Gastroenterol 2004; 99: 1652-6.

  16. Carlsson R, Dent J, Bolling-Sternevald E, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998; 33: 1023-9.

  17. Gómez-Escudero O, Remes-Troche JM, Ruiz JC y cols. Utilidad diagnóstica del cuestionario de Carlsson-Dent para enfermedad por reflujo gastroesofágico. Rev Gastroenterol Mex 2003; 68(Supl. 3): 87.

  18. Gavilán VE, Gotilla JI, Luzuriaga MG, et al. Valoración del índice cintura-cadera y su correlación con el riesgo cardiovascular en un hospital de la ciudad de Corrientes. Servicio de Cardiología Hospital “J. de San Martín”.

  19. Uscanga L, Nogueira-de-Rojas JR, Gallardo E, y el Grupo Mexicano para el Estudio de la Enfermedad por Reflujo Gastroesofágico. Enfermedad por reflujo gastroesofágico. Resultados del Consenso del Grupo Mexicano para el Estudio de la ERGE. Asociación Mexicana de Gastroenterología. Rev Gastroenterol Méx 2002; 67(3): 216-23.

  20. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999; 45: 172-180

  21. Mittal RK, Balaban DH. The esophagogastric junction. N Engl J Med 1997; 336(13): 924-30.

  22. Shah A, Uribe J, Katz PO. Gastroesophageal reflux disease and obesity. Gastroenterol Clin N Am 2005; 34: 35-43.

  23. Bolúmar MF, Vioque LJ, Rebagliato RM. Estudios descriptivos ecológicos. Estudios transversales. En: Gil P. Medicina preventiva y salud pública. 10ª. Ed. Barcelona, España: Masson; 2001, p. 96-101

  24. Pandolfino JE, El-Serag HB, Zhang Q, et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 2006.

  25. Jacobson BC, Somers SC, Fuchs CS, et al. Body-Mass Index and Symptoms of Gastroesophageal Reflux in Woman. N Engl J Med 2006; 354(22): 2340-48.

  26. Stene-Larsen G, Weberg R, Froyshov Larsen I, et al. Relationship of overweight to hiatus hernia and reflux oesophagitis. Scand J Gastroenterol 1988; 23: 427-32.

  27. Corley DA, Kubo A, Body Mass Index and Gastroesophageal Reflux Disease: A Systemic Review and meta-Analysis. Am J Gastroenterol 2006; 108: 2619-28.

  28. Locke GR, Talley NJ, Fett SL, et al. Risk factors associated with symptoms of gastroesophavgeal reflux. Am J Med 1999;106:642-649

  29. Murray L, Johnston B, Lane A, et al. Relationship between body mass and gastroesphageal reflux symptoms: the Bristol Helicobacter pylori Project. Int J Epidemiol 2003; 32: 645-50.

  30. Diaz-Rubio M, Moreno-Elola-Olasco C, Rey E, et al. Symptoms of gastro-esophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther 2004; 19: 95-105.

  31. Nilsson M, Johnsen R, Ye W, et al. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA 2003; 290: 66-72.

  32. Oliveria SA, Christos PJ, Talley NJ, et al. Heartburn risk factors, knowledge, and prevention strategies: a population-based survey of individuals with heartburn. Arch Intern Med 1999; 159: 1592-8.

  33. Lagergren J, Bergstrom R, Nyren O. No relation between body mass an gastroesophageal reflux symptoms in a Swedish population-based study. Gut 2000; 47: 26-9.

  34. Wu AH, Tseng CC, Bernstein L. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer 2003; 98: 940-8.

  35. Andersen LI, Jensen G. Risk factors for bening oesophageal disease in a random population sample. J Intern Med 1991; 230: 5-10.




2020     |     www.medigraphic.com