Clinical–alimentary tractObesity Is Associated With Increased Transient Lower Esophageal Sphincter Relaxation
Section snippets
Subjects
We prospectively recruited consecutive obese (BMI >30 kg/m2) patients who were referred for globus, noncardiac chest pain, or preoperative assessment of weight reduction procedures because of moderate to severe obesity. During the same study period, nonobese patients with globus and noncardiac chest pain were recruited as controls. All patients with globus and noncardiac chest pain had failure of symptom response to an 8-week therapeutic trial of proton pump inhibitor. The controls were further
Results
From August 2003 to September 2005, 28 obese subjects, 28 overweight subjects, and 28 normal weight controls were studied. Sixteen subjects in each group were male. The demographics and anthropometric data are presented in Table 1. Noncardiac chest pain was the indication for the motility study in 12 (43%) normal weight subjects and 5 (18%) overweight subjects. None of the subjects with globus and noncardiac chest pain had symptom response to proton pump inhibitors. Six (21.4%) patients in the
Discussion
Obesity has been implicated as a major risk factor of GERD and its complication. Many studies have reported an association between obesity, hiatus hernia, and various motility dysfunctions of the upper gastrointestinal tract in GERD patients. However, it is arguable whether obesity predisposes to these conditions or whether they merely coexist in GERD. To solve this controversy, we set out to evaluate the relationship between obesity and functional integrity of GOJ in subjects without GERD. In
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