title: Increased body mass index after H. pylori eradication for duodenal ulcer predisposes to erosive reflux esophagitis.
abstract: BACKGROUND
  A higher body mass index (BMI) may lead to a more adverse outcome of reflux esophagitis. The study aimed to determine whether increased BMI after H. pylori eradication in duodenal ulcer patients predisposes to erosive reflux esophagitis.
  
  
  METHODS
  Four hundred fifty-nine patients with Helicobacter pylori-positive duodenal ulcers but without reflux esophagitis were evaluated. Serial BMIs were collected before therapy and on the 2nd, 6th, and 12th months after H. pylori eradication. New-onset reflux esophagitis was recorded.
  
  
  RESULTS
  In 350 patients with complete follow-up, mean BMI increased from the second month after H. pylori eradication (P<0.001). H. pylori eradication also led to a net increase of BMI >1.5 kg/m in nearly 20% of patients in the 12-month follow-up, whereas new-onset of reflux esophagitis was noted in 16.3% (57/350). Baseline BMI, prevalence rate of hiatus hernia, and net increase of BMI were higher in patients with new-onset reflux than in those without (P<0.05). Multiple logistic regression confirmed higher baseline BMI, hiatus hernia, and net BMI increase >1.5 kg/m after H. pylori eradication were independently associated with new-onset reflux esophagitis (P<0.05).
  
  
  CONCLUSIONS
  Eradication of H. pylori may lead to a significant net increase of BMI in patients with duodenal ulcers. Such BMI gain, as well as higher baseline BMI and hiatus hernia, predisposes to new-onset reflux esophagitis after H. pylori eradication.
authors.affiliation: Department of Pediatrics, National Cheng Kung University Medical Center, Tainan, Taiwan. sheubs@mail.ncku.edu.tw
authors.forename: Yao-Jong
authors.initials: YJ
authors.lastname: Yang
authors.forename: Bor-Shyang
authors.initials: BS
authors.lastname: Sheu
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Chang
authors.forename: Hsui-Chi
authors.initials: HC
authors.lastname: Cheng
authors.forename: Hsiao-Bai
authors.initials: HB
authors.lastname: Yang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004381:Duodenal Ulcer / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects; D006551:Hernia, Hiatal / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors