ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2009
Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 3 syntheses or guidelines pooled it, 197 citations in OpenAlex.
- Contemporary esophageal physiological testing for primary esophageal motility disorder (PEMD) and gastroesophageal reflux disease (GERD) before bariatric surgery: A systematic literature review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Pooled it
- European guideline on obesity care in patients with gastrointestinal and liver diseases - Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline.United European gastroenterology journal · 2022Guideline
- Association of Serum Levels of Adipokines and Insulin With Risk of Barrett's Esophagus: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2015Pooled it
- Comparison of Gastric Residual Volume After Ingestion of A Carbohydrate Drink and Water in Healthy Volunteers with Obesity: A Randomized Crossover Study.Obesity surgery · 2024Trial
- Prediction of response to PPI therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole.BMC gastroenterology · 2011Trial
- Predictors of Gastroesophageal Reflux Disease Following Bariatric Surgery Assessed by Ambulatory pH Monitoring.Obesity surgery · 2026Article
- Gastroesophageal reflux disease and temporomandibular disorder risk: a nationwide cohort study.BMC oral health · 2026Article
- Physiological response of lower esophageal sphincter pressure to abdominal pressure in obese individuals: a retrospective cross-sectional study.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- Laryngopharyngeal Reflux: The Impact of Obesity.World journal of otorhinolaryngology - head and neck surgery · 2025Article
- [Gastroesophageal Reflux Disease].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025Review
- Gastroesophageal reflux disease symptoms after sleeve gastrectomy with anterior hemifundoplication: a pilot study.ANZ journal of surgery · 2025Article
- Insight into global burden of gastroesophageal reflux disease: Understanding its reach and impact.World journal of gastrointestinal pharmacology and therapeutics · 2025Review
- Unveiling the intricacies: Insight into gastroesophageal reflux disease.World journal of gastroenterology · 2025Review
- Novel perspectives on the link between obesity and cancer risk: from mechanisms to clinical implications.Frontiers of medicine · 2024Review
- Update Motility Disorders: Gastro-Oesophageal Reflux Disease - Diagnostic and Conservative Approach.Visceral medicine · 2024Review
- The Economic Impact of Introducing RefluxStop for Refractory Gastroesophageal Reflux Disease on the Italian Healthcare System.PharmacoEconomics - open · 2024Article
- A New Surgical Approach for Obese Patients with Hiatal Hernia.Obesity surgery · 2024Article
- Pathophysiology of gastro-oesophageal reflux disease: implications for diagnosis and management.Nature reviews. Gastroenterology & hepatology · 2024Review
- Unraveling the pathogenesis of Barrett's esophagus and esophageal adenocarcinoma: the "omics" era.Frontiers in oncology · 2024Review
- Gastroesophageal reflux in lockdown.Future science OA · 2023Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionObesity and gastroesophageal reflux disease (GERD) are increasingly important health problems. Previous studies of the relationship between obesity and GERD focus on indirect manifestations of GERD. Little is known about the association between obesity and objectively measured esophageal acid exposure. The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms.
methodsData of 1,659 patients (50% male, mean age 51 +/- 14) referred for assessment of GERD symptoms between 1998 and 2008 were analyzed. These subjects underwent 24-h pH monitoring off medication and esophageal manometry. The relationship of BMI to 24-h esophageal pH measurements and LES status was studied using linear regression and multiple regression analysis. The difference of each acid exposure component was also assessed among four BMI subgroups (underweight, normal weight, overweight, and obese) using analysis of variance and covariance.
resultsIncreasing BMI was positively correlated with increasing esophageal acid exposure (adjusted R (2) = 0.13 for the composite pH score). The prevalence of a defective LES was higher in patients with higher BMI (p < 0.0001). Compared to patients with normal weight, obese patients are more than twice as likely to have a mechanically defective LES [OR = 2.12(1.63-2.75)].
conclusionAn increase in body mass index is associated with an increase in esophageal acid exposure, whether BMI was examined as a continuous or as a categorical variable; 13% of the variation in esophageal acid exposure may be attributable to variation in BMI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.