Symptoms of heartburn and GERD are highly prevalent among obese patients

Nov 1 2004

Symptoms of heartburn and GERD are highly prevalent among obese patients according to research presented at the 69th Annual Scientific Meeting of the American College of Gastroenterology.

In a separate study that examined obesity as a risk factor for esophageal adenocarcinoma researchers found an association between body mass index (BMI) and risk of cancer of the esophagus.

Dr. Mary Thomas of University Hospital at Stony Brook examined a consecutive series of 56 morbidly obese patients for the prevalence of GERD symptoms, acid reflux, and esophagitis. Her study compared the symptoms experienced by morbidly obese patients with those reported by the population of Olmsted City, MN. Additionally, some of the obese patients underwent ambulatory esophageal pH testing, and findings were compared with data from asymptomatic volunteers.

Overall, heartburn and or acid regurgitation were found among 75 percent of the morbidly obese patients, while 23 percent experienced difficulty swallowing (dysphagia) and 34 percent experienced asthma symptoms. These symptoms of GERD were more prevalent among the obese patients than in the general population. Similarly, measures of acid reflux from the esophageal pH monitoring found higher prevalence (64 percent) of reflux among obese patients than among asymptomatic volunteers (30 percent). These findings suggest a higher prevalence of GERD symptoms among obese patients than has been reported.

Heiko Pohl, M.D. and Douglas Robertson, M.D. of the VA Medical Center in White River Junction, VT performed a systematic review of all case-control or controlled cohort studies that examined risk of esophageal adenocarcinoma across multiple categories of body mass index. Among nine studies between 1996 and 2004 involving a total of 1,103 patients with esophageal cancer, seven studies found obesity to be a risk factor; two found no association. Four studies found a significant dose-dependent association between body mass index and risk. As BMI increased so did risk of esophageal adenocarcinoma.

Dr. Pohl and Dr. Robertson found those in the highest BMI group were 3.5 times more likely to develop esophageal adenocarcinoma than patients in the lowest BMI group, which included individuals of normal weight. Adjusting for other possible risk factors such as GERD, smoking or a diet low in vegetables, had minimal affect on this outcome.