Archives of Medical Research
Volume 40, Issue 7 , Pages 576-581, October 2009

Effect of Body Weight and Esophageal Damage on the Severity of Gastroesophageal Reflux Symptoms. Mexican GERD Working Group

  • Juan Carlos Lopez-Alvarenga

      Affiliations

    • Southwest Foundation for Biomedical Research, San Antonio, Texas
    • Department of Research, Hospital Regional de Veracruz, Veracruz, Mexico
    • Corresponding Author InformationAddress reprints requests to: Juan Carlos Lopez-Alvarenga, Department of Genetics, Southwest Foundation for Biomedical Research, 7620 NW Loop 410, San Antonio 78227, TX; Phone: 78245-0549
  • ,
  • José Antonio Vargas

      Affiliations

    • ALTANA Pharma SA de CV, Mexico, Naucalpan de Juarez, Estado de México, Mexico
  • ,
  • Luis Humberto Lopez

      Affiliations

    • Facultad de Medicina, Universidad de Guanajuato, León, Guanajuato, México
  • ,
  • Ronnie Fass

      Affiliations

    • Health Sciences Center and University Medical Center, University of Arizona, Tucson, Arizona
  • ,
  • Sergio Sobrino-Cossio

      Affiliations

    • Servicio de Endoscopía, Instituto Nacional de Cancerología, Mexico, D.F., Mexico
  • ,
  • Paul Higgins

      Affiliations

    • Southwest Foundation for Biomedical Research, San Antonio, Texas
  • ,
  • Anthony Comuzzie

      Affiliations

    • Southwest Foundation for Biomedical Research, San Antonio, Texas

Received 4 June 2008; accepted 27 July 2009.

(ARCMED-D-09-00245)

Background and Aims

Several studies have demonstrated overweight and obesity are strong independent risk factors of GERD symptoms and esophageal erosions. Our aim was to analyze the joint effect of BMI with the grade of esophageal damage over symptoms' intensity of GERD.

Methods

We used a questionnaire with a Likert scale for severity of symptoms related to GERD. The distal portion of the esophagus was evaluated to determine the presence of mucosal injury, classified by Los Angeles criteria (LA).

Results

We included 917 subjects (53.76% females) with average age 36.8±7 years. Males had higher BMI than females (26.8±3.5 vs. 25.2±4.5, p<0.001). Severe damage (C–D ulcers) was associated with overweight (BMI 25–30), severity of heartburn,retching, halitosis, regurgitation, and chest oppression. BMI >30 had high score for heartburn and retching, but low score for nausea, compared with lower weight. The model with interaction showed a non-linear association between BMI and LA. Overweight (but not obese) patients with damage scored C–D had the highest score for intensity of heartburn and retching.

Conclusions

BMI and LA do not have additive effects on the severity of symptoms of GERD. Those with BMI between 25 and 30 had severe symptoms score, but those with BMI >30 showed lower scores. These findings could explain controversial results found in other studies.

Key Words: Gastroesophageal reflux, Endoscopy, Heartburn, Obesity, Esophageal disease, Pain sensation

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PII: S0188-4409(09)00141-6

doi:10.1016/j.arcmed.2009.08.003

Archives of Medical Research
Volume 40, Issue 7 , Pages 576-581, October 2009