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.
Fornari
Fernando
F
Faculdade de Medicina, Universidade de Passo Fundo, Rua Teixeira Soares, 817, Passo Fundo-RS, 99010-080, Brazil. FernandoFornari@gmail.com
Callegari-Jacques
Sidia M
SM
Dantas
Roberto Oliveira
RO
Scarsi
Ana Lúcia
AL
Ruas
Liana Ortiz
LO
de Barros
Sérgio Gabriel Silva
SG
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