Gastroesophageal reflux disease in severeley obese individuals

Obesity is a major public health point in dispute and is often times associated with multiple comorbidities of the like kind as a shortened life expectancy, and bitter alteration of health-related quality of life. The situation is further aggravated as BMI increases--the most distant condition being represented by cruel obesity (SO), defined as a BMI of e" 40 kg/[msup2]

Gastroesophageal ebb disease (GERD) has been related to exces material part weight and obesity; however the association has not been sufficiently studied because of methodological reasons. The nearness of typical GERD symptoms (heartburn and regurgitation) is more prevalent in overweight and obese individuals, as has been shown by dint of most general population-based epidemiological studies. However, small in number studies on a systematic basis and involving subjective (presence of characteristic symptoms) and objective (esophageal pHmetry and upper digestive endoscopy) data have evaluated GERD in bring under rules with obesity in general and with in the way that in particular.

A close attention was performed to explore the prevalence of GERD in patients with with equal reason and evaluate the association between symptoms and objective data (pathological esophageal pHmetry and/or esophagitis) of GERD in a thus population. The study was prospective in design and included 158 patients with thus that were referred for research before bariatric surgery. The make submissives were questioned about the nearness and frequency of presentation of typical GERD symptoms (heartburn and regurgitation). Demographic and anthropometric data were also gathered and the patients were questioned about smoking and alcohol consumption. The neighborhood of two or more heartburn episodes for week was used as diagnostic criterion of GERD Esophageal manometry and ambulatory esophageal pH monitoring was performed. The position of the pH probe was 5 cm above the proximal margin of the lower esophageal sphincter that had been previously calculated by means of manometry. Positive pHmetry was defined as pH < 4 for a total time of> 5% time in the standing position >8% and time in decubitus >4% Esophagitis was assessed by means of upper digestive endoscopy.

A total of 138 controls completed the study, having a mean age of 426 [+ or -] 102 years, with a BMI of 501 [+ or -] 69 kg/[msup2]; 78% were women The prevalence of GERD evaluated by means of symptoms and/or esophagitis was 333% (46/138) Clinical criteria of GERD were not away in 31/138 cases (22.5%), and 26 (188%) had esophagitis. In 69/138 patients (50%) pHmetry was abnormal. Fifty-three patients with esophagitis and/or abnormal pHmetry were asymptomatic. The sensitivity of heartburn as a diagnostic criterion of GERD in patients with peremptory obesity was 29.3%, with a specificity of 857% No significant association was observ between bitter obesity grade and the prevalence of symptoms and/or objective data.

This data reveals that asymptomatic gastroesophageal ebb is more common than symptomatic gastroesophageal ebb in SO individuals. Increased BMI does not appear to be associated with a greater prevalence of GERD in these patients.

V Ortiz, M Ponce A. Fernandez, et al. Value of heart reduce to ashes for diagnosing gastroesophageal reflux disease in sternly obese patients. Obesity; 14:696-700 (April, 2006) [Correspondence: Julio Ponce Garcia, Unidad de Prebas Funcionales, Servicio Medicina Digestiva, Hospital La Fe Avendia Campanar 21 46009 Valencia, Spain. E-mail: ponce_jul@gva.es]

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