Research Article
Obesity is a Risk Factor for Erosive Gastroesophageal Reflux Disease: Prospective Case-Control Study
Nicola de Bortoli1*, Guido Salvetti2, Lorenzo Bertani1, Irene Martinucci1, Edoardo Savarino3, Paola Fierabracci2, Roberta Jaccheri2, Jacopo Vitti2, Andrea Pucci2, Massimo Bellini1, Linda Ceccarelli1, Salvatore Russo1, Riccardo Franchi1, Solito Biagio4, Santi Stefano4, Marco Anselmino5, Ferruccio Santini2 and antino Marchi11Division of Gastroenterology, Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy
2Obesity Center, Department of Internal Medicine, University of Pisa, Pisa, Italy
3Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
4Division of Esophageal Surgery, Department of Gastroenterology, AOU Pisana, Pisa, Italy
5Division of Bariatric Surgery, Department of Gastroenterology, AOU Pisana, Pisa, Italy
- *Corresponding Author:
- Nicola de Bortoli
Gastroenterology Unit
Department of Translational Research and New Technology
University of Pisa, Italy
Cisanello Hospital, Via Paradisa 2 – 56124 Pisa (PI) – Italy
Tel: +39 050 997395
Fax: +39 050 997398
E-mail: nick.debortoli@gmail.com
Received date: June 06, 2014; Accepted date: June 17, 2014; Published date: June 25, 2014
Citation: Bortoli N, Salvetti G, Bertani L, Martinucci I, Savarino E, et al. (2014) Obesity is a Risk Factor for Erosive Gastroesophageal Reflux Disease: Prospective Case-Control Study. J Gastroint Dig Syst 4:194. doi:10.4172/2161-069X.1000194
Copyright: © 2014 Bortoli ND, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background and aim: An association between high body mass index (BMI) and gastroesophageal reflux disease (GERD) has been proposed but the relationship between the severity of obesity, the prevalence of symptoms and gravity of esophagitis is still unclear. Aim of this study was to evaluate the prevalence of symptomatic GERD and esophagitis in female obese subjects compared to a group of female with typical GERD symptoms. Material and methods: 193 obese women (Group A) scheduled for bariatric surgery and 193 normal weight female with typical GERD symptoms (Group B) were submitted to complete history (recording voluptuary habits) and validated questionnaire for symptomatic diagnosis of GERD (GIS: GERD Impact Scale). Each patient underwent upper GI endoscopy to evaluate the prevalence of erosive esophagitis. Erosive esophagitis was diagnosed according to Los Angeles Classification of esophagitis. Results: We enrolled 193 female patients in Group A and 193 patients in Group B. Mean age (± sd) was 48.6 ± 13.6 years in Group A and 51.4 ± 15.3 years in group B. Mean BMI was 43.6 ± 9.2 in group A and 23.6 ± 3.7 in Group B (P<0.001). The perception of GERD symptoms was higher in group B: the mean value of GIS was 1.72 when compared with 0.34 obtained in Group A (P<0.001). The mean value of score for typical GERD symptoms was 2.65 in group B and 0.85 in group A (P<0.001). All patients in Group B recorded at least one typical GERD symptom (heartburn and regurgitate) but only 26.9% of patients in Group A recorded these symptoms (P<0.001). Esophageal erosion were present in 97/193 (50.3%) in Group A and in 45/193 (23.3%) in Group B (P<0.001). Conclusions: We can conclude that the impact of erosive esophagitis in obese patients could be considered more severe than gravity and frequency of symptoms.