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

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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.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Faculdade de Medicina, Universidade de Passo Fundo, Rua Teixeira Soares, 817, Passo Fundo-RS, 99010-080, Brazil

    Fernando Fornari, Ana Lúcia Scarsi & Liana Ortiz Ruas

  2. ENDOPASSO, Passo Fundo-RS, Brazil

    Fernando Fornari

  3. Departamento de Estatística e Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil

    Sidia M. Callegari-Jacques

  4. Departamento de Medicina, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto-SP, Brazil

    Roberto Oliveira Dantas

  5. Programa de Pós-Graduação: Ciências em Gastroenterologia, Faculdade de Medicina, UFRGS, Porto Alegre-RS, Brazil

    Fernando Fornari & Sérgio Gabriel Silva de Barros

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  1. Fernando Fornari
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  2. Sidia M. Callegari-Jacques
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  3. Roberto Oliveira Dantas
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  4. Ana Lúcia Scarsi
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  6. Sérgio Gabriel Silva de Barros
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Correspondence to Fernando Fornari.

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Fornari, F., Callegari-Jacques, S.M., Dantas, R.O. et al. Obese Patients Have Stronger Peristalsis and Increased Acid Exposure in the Esophagus. Dig Dis Sci 56, 1420–1426 (2011). https://doi.org/10.1007/s10620-010-1454-4

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  • DOI: https://doi.org/10.1007/s10620-010-1454-4

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