Obese patients have stronger peristalsis and increased acid exposure in the esophagus.
BACKGROUND
Obesity is a risk factor for GERD and a potential modulator of esophageal motility.


OBJECTIVE
To assess whether obese patients differ from non-obese patients in terms of esophageal motility and reflux.


METHODS
Patients (n = 332) were categorized in GERD and controls after clinical assessment, esophageal manometry, and pH monitoring. Non-obese (BMI 16-29.9) and obese (BMI 30-68) were compared in regard of distal esophageal amplitude (DEA), LES pressure (LESP), manometric diagnosis, and esophageal acid exposure (EAE).


RESULTS
Obese showed higher DEA in both controls (122 ± 53 vs. 97 ± 36 mmHg, p = 0.041) and GERD patients (109 ± 38 vs. 94 ± 46 mmHg, p < 0.001), higher LESP in GERD patients (20.5 ± 10.6 vs. 18.2 ± 10.6 mmHg, p = 0.049), higher frequency of nutcracker esophagus in controls (30 vs. 0%, p = 0.001), lower frequency of ineffective motility in GERD patients (6 vs. 20%, p = 0.001), and higher EAE in both controls [total EAE: 1.6% (0.7-5.1) vs. 0.9% (0.2-2.4), p = 0.027] and GERD patients [upright EAE: 6.5% (3.8-11.1) vs. 5.2% (1.5-10.6), p = 0.048]. Multiple linear regression showed that BMI was associated either with EAE (p < 0.001), DEA (p = 0.006), or LESP (in men, p = 0.007).


CONCLUSIONS
Obese patients differed from non-obese in terms of esophageal motility and reflux, regardless of the presence of GERD. Obese patients showed stronger peristalsis and increased acid exposure in the esophagus.
Faculdade de Medicina, Universidade de Passo Fundo, Rua Teixeira Soares, 817, Passo Fundo-RS, 99010-080, Brazil. FernandoFornari@gmail.com
Fernando
F
Fornari
Sidia M
SM
Callegari-Jacques
Roberto Oliveira
RO
Dantas
Ana Lúcia
AL
Scarsi
Liana Ortiz
LO
Ruas
Sérgio Gabriel Silva
SG
de Barros
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000473:pathology* / Q000502:physiology; D005260:Female; D005744:Gastric Acid / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010528:Peristalsis / Q000502:physiology*; D055815:Young Adult