Pathological gastroesophageal reflux in patients with severe obesity

Background: Overweight can be a risk factor for pathological gastroesophage al reflux or biatal hernia. Aim: To study the prevalence of gastroesophagea l reflux in patients with severe obesity. Patients and methods: Sixty seven patients, 51 female, aged 17 to 56 years old with a body mass index over 3 5 kg/m(2) were studied. An upper gastrointestinal endoscopy was performed i n all, esophageal manometry was done in 32 and 24 h pH monitoring was done in 32 patients. Results: Seventy nine percent of patients complained of hea rtburn and 66% of regurgitation. In 16 patients, endoscopy was normal. An e rosive esophagitis was found in 33 patients, a short columnar epithelium in 12 and a Barret esophagus with intestinal metaplasia in six. Normal endosc opic findings and erosive esophagitis were present with a higher frequency in women. No association between the degree of obesity and esophageal lesio ns was observed. Lower esophageal sphincter pressure and abdominal length w ere significantly higher in subjects with a body mass index over 50 compare d to those with a body mass index between 35 and 39.9 kg/m(2). No differenc es were observed in 24 h pH monitoring. Conclusions: A high proportion of s everely obese patients had symptoms and endoscopical findings of pathologic al gastroesophageal reflux (Rev Med Chile 2001; 129: 1038-43).