Relationship between obesity and gastroesophageal reflux disease as recorded by 3-hour esophageal pH monitoring.

OBJECTIVE: To evaluate the presence of gastroesophageal reflux disease (GERD) in a Greek cohort in relationship to the body mass index (BMI), using the 3-hr postprandial esophageal pH monitoring. METHODS: Sixty-four consecutive patients (55 males, 9 females; mean age 40.7 +/- 13.7 years) with at least weekly attacks of heartburn or acid regurgitation for a period longer than one year, were screened endoscopically for esophagitis and underwent a 3-hr postprandial pH monitoring to quantify the reflux. DeMeester score was calculated. The patients were allocated to three groups: group A (reference group, n=23) with BMI < 25 kg/m(2) (normal); group B (n=25) with BMI 25-30 kg/m(2) (overweight), and group C (n=16) with BMI > 30 kg/m(2) (obese). RESULTS: A higher DeMeester score, as well as a decreased lower esophageal sphincter pressure were evidenced with increasing BMI. Moreover, there was an association between increasing BMI and the point scale of reflux symptoms. The number of cases with severe reflux symptoms increased significantly among overweight (odds ratio: 4.94, 95%CI: 0.95-25.56) and obese (odds ratio: 8.18, 95%CI: 1.19-56.00) patients. CONCLUSIONS: The shorter 3-hr postprandial test appears to be diagnostic for GERD and acceptable by patients, reducing discomfort and enhancing compliance. Our study confirms the link between obesity and GERD. BMI is strongly associated with the point scale of reflux symptoms both in overweight and obese patients.