The prevalence of obesity has more than doubled in United States over the past 3 decades.
1
The increased prevalence of obesity has also corresponded with a parallel increased
prevalence of gastroesophageal reflux disease (GERD). In fact, obese patients have
a 2.5 times elevated risk of developing GERD symptoms.
2
Pandolfino et al 1st proposed a physiopathologic mechanism by which obesity may lead
to GERD. Pandolfino et al
3
have shown that increased visceral fat in obese patients may increase their intragastric
pressure with a resulting increased gastroesophageal pressure gradient and abnormal
esophageal acid exposure. Other studies have also shown that central obesity (a marker
for increased visceral fat) is associated with Barrett's esophagus, a known complication
of GERD. As shown by Edelstein et al,
4
the odds of developing long-segment Barrett's esophagus were 4.3 for patients with
the highest waist-to-hip ratio. With such a strong association between Barrett's esophagus
and obesity, the prevalence of esophageal adenocarcinoma in obese patients has also
been found to be substantial. An obese individual has an odds ratio of 16.2 for developing
esophageal adenocarcinoma compared with an individual with a BMI less than 22.
5
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References
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Article info
Publication history
Published online: April 25, 2014
Received in revised form:
March 30,
2014
Received:
March 10,
2014
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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