Original Article

Digestive Diseases and Sciences

, Volume 56, Issue 5, pp 1420-1426

First online:

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

  • Fernando FornariAffiliated withFaculdade de Medicina, Universidade de Passo FundoENDOPASSOPrograma de Pós-Graduação: Ciências em Gastroenterologia, Faculdade de Medicina, UFRGS Email author 
  • , Sidia M. Callegari-JacquesAffiliated withDepartamento de Estatística e Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS)
  • , Roberto Oliveira DantasAffiliated withDepartamento de Medicina, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
  • , Ana Lúcia ScarsiAffiliated withFaculdade de Medicina, Universidade de Passo Fundo
  • , Liana Ortiz RuasAffiliated withFaculdade de Medicina, Universidade de Passo Fundo
  • , Sérgio Gabriel Silva de BarrosAffiliated withPrograma de Pós-Graduação: Ciências em Gastroenterologia, Faculdade de Medicina, UFRGS

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Abstract

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.

Keywords

Body mass index Esophageal motility disorders Gastroesophageal reflux disease Obesity