Obese Patients Have Stronger Peristalsis and Increased Acid Exposure in the Esophagus

• Published in: Digestive diseases and sciences Vol. 56; no. 5; pp. 1420 - 1426
• Main Authors: Fornari, Fernando, Callegari-Jacques, Sidia M., Dantas, Roberto Oliveira, Scarsi, Ana Lúcia, Ruas, Liana Ortiz, de Barros, Sérgio Gabriel Silva
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.05.2011; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biochemistry; Biological and medical sciences; Body Mass Index; Comparative analysis; Esophageal pH Monitoring; Esophagus; Esophagus - pathology; Esophagus - physiology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastric Acid - physiology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal reflux; Gastroesophageal Reflux - diagnosis; Hepatology; Humans; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Metabolic diseases; Middle Aged; Obesity; Obesity - complications; Oncology; Original Article; Other diseases. Semiology; Peristalsis - physiology; Transplant Surgery; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult; Body mass index; Obesity; Esophageal motility disorders; Gastroesophageal reflux disease; Human; Gastroesophageal reflux; Esophageal disease; Nutrition disorder; Metabolic diseases; Peristalsis; Esophagus; Motility disorder; Gastroenterology; Digestive diseases; Nutritional status
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-010-1454-4

Background Obesity is a risk factor for GERD and a potential modulator of esophageal motility. Aim 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.