GERD & Heartburn: Highly Prevalent in Morbidly Obese Patients
Dr. Mary Thomas of University Hospital at Stony Brook examined a consecutive series of 56 morbidly obese patients for the prevalence of GERD symptoms, acid reflux, and esophagitis. Her study compared the symptoms experienced by morbidly obese patients with those reported by the population of Olmsted City, MN. Additionally, some of the obese patients underwent ambulatory esophageal pH testing, and findings were compared with data from asymptomatic volunteers.
Overall, heartburn and or acid regurgitation were found among 75 percent of the morbidly obese patients, while 23 percent experienced difficulty swallowing (dysphagia) and 34 percent experienced asthma symptoms. These symptoms of GERD were more prevalent among the obese patients than in the general population. Similarly, measures of acid reflux from the esophageal pH monitoring found higher prevalence (64 percent) of reflux among obese patients than among asymptomatic volunteers (30 percent). These findings suggest a higher prevalence of GERD symptoms among obese patients than has been reported.
Increasing BMI Associated with Increasing Risk of Esophageal Cancer
Heiko Pohl, M.D. and Douglas Robertson, M.D. of the VA Medical Center in White River Junction, VT performed a systematic review of all case-control or controlled cohort studies that examined risk of esophageal adenocarcinoma across multiple categories of body mass index. Among nine studies between 1996 and 2004 involving a total of 1,103 patients with esophageal cancer, seven studies found obesity to be a risk factor; two found no association. Four studies found a significant dose-dependent association between body mass index and risk. As BMI increased so did risk of esophageal adenocarcinoma.
Dr. Pohl and Dr. Robertson found those in the highest BMI group were 3.5 times more likely to develop esophageal adenocarcinoma than patients in the lowest BMI group, which included individuals of normal weight. Adjusting for other possible risk factors such as GERD, smoking or a diet low in vegetables, had minimal affect on this outcome.
About Esophageal Cancer
Studies have linked chronic, longstanding, untreated heartburn with an increased risk of esophageal cancer. During the past 30 years, the incidence of adenocarcinoma of the esophagus, a rare and highly fatal form of cancer, has rapidly increased in the United States. According to the American Cancer Society, between 1970 and 2000, the incidence of adenocarcinoma of the esophagus increased seven-fold in the United States. This year 14,250 Americans will be diagnosed with esophageal cancer, and 13,330 will die.
The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal (GI) tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. Consumers can get more information on GI diseases through the following ACG-sponsored programs:
- 1-800-978-7666 (free brochures on common GI disorders, including ulcer, colon cancer, gallstones, and liver disease)
- 1-866-IBS-RELIEF and www.ibsrelief.org (free educational materials)
- 1-800-HRT-BURN (free brochure and video on heartburn and GERD)
- www.acg.gi.org (ACG's Web site)