Obese Patients Have Stronger Peristalsis and Increased Acid Exposure in the Esophagus
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Fernando Fornari Sidia M. Callegari-Jacques Roberto Oliveira Dantas Ana Lu´ cia Scarsi Liana Ortiz Ruas Se´rgio Gabriel Silva de Barros
- چاپ و سال / کشور: 2010
Description
Background Obesity is a risk factor for GERD and a potential modulator of esophageal motility. Aim To assess whether obese patients differ from nonobese 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.
Dig Dis Sci (2011) 56:1420–1426 DOI 10.1007/s10620-010-1454-43 Received: 1 January 2010 / Accepted: 30 September 2010 / Published online: 24 October 2010
