DOES MASSIVE OBESITY PROMOTE ABNORMAL GASTROESOPHAGEAL REFLUX

Fifty consecutive massively obese patients referred for gastroplasty o perations were prospectively studied to determine the existence of gas troesophageal reflux disease by means of a standardized questionnaire, 24-hr ambulatory pH-metry, and endoscopy (27 females, mean age 48 yea rs, range 38-57 years). These patients had a body mass index (BMI) of 42.5 +/- 5.2 kg/m(2) and an actual weight of 125.5 +/- 17 kg. Heartbur n and acid regurgitation was reported by 37% and 28%, respectively, mo stly of a mild degree (22% and 20%). Dysphagia was reported by 2%, but none had odynophagia. No patient had any macroscopic esophagitis. The pH data were compared with those obtained in 29 age- and sex-matched, symptom-free, healthy controls (15 females, mean age 47.6 years, rang e 30-63 years). During ambulatory pH-metry, we recorded a predominance of daytime reflux (7.2 +/- 8.2% and a total acid exposure of 5.3 +/- 6.4%) in the obese patients, but neither the weight, BMI, nor the wais t-hip ratio were significantly correlated with any of the reflux varia bles. The pH data obtained from these patients did not, however, diffe r significantly from those recorded in the control population, althoug h a somewhat lower daytime acid reflux was found in the latter group. These results suggest that massive overweight is not associated with a n increased prevalence of gastroesophageal reflux disease.