ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2020
Higher Esophageal Symptom Burden in Obese Subjects Results From Increased Esophageal Acid Exposure and Not From Dysmotility.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 28 citations in OpenAlex.
- Application of High-Resolution Impedance Manometry for Evaluation of Gastroesophageal Reflux Disease in Patients with Obesity Based on the Updated Lyon Consensus 2.0 and Chicago Classification v4.0.Obesity surgery · 2026Article
- Special findings in high-resolution manometry prior to metabolic surgery: obesity as a risk factor for esophagogastric junction outflow obstruction or achalasia?Surgical endoscopy · 2026Article
- Concurrent hiatal hernia repair and gastric bypass as an adjunct in the treatment of hiatal hernia in populations with obesity.Surgical endoscopy · 2025Article
- Associations of Metabolically Healthy Obesity with Gastroesophageal Reflux Disease and Ineffective Esophageal Motility.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Higher obesity class is associated with more severe esophageal symptoms and reflux burden but not altered motor function or contractile reserve.Neurogastroenterology and motility · 2024Article
- Comparison of Esophageal Dysmotility and Reflux Burden in Patients with Different Metabolic Obesity Phenotypes Based on High-Resolution Impedance Manometry and 24-h Impedance-pH.Obesity facts · 2024Article
- Clinical Characteristics of Esophageal Motility Disorders in Patients With Heartburn.Journal of neurogastroenterology and motility · 2021Article
- Artificial intelligence automates and augments baseline impedance measurements from pH-impedance studies in gastroesophageal reflux disease.Journal of gastroenterology · 2021Observational
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsEsophageal motor disorders (EMD) and pathologic reflux are often identified in obese individuals, but it is not clear how obesity contributes to these symptoms. We examined the relationships among symptom burden, EMD, acid exposure time (AET), symptom association probability, and body mass index (BMI).
methodsWe performed a retrospective study of 1089 consecutive patients who underwent high-resolution manometry, of which 426 patients also underwent reflux monitoring off acid suppression, over a 2-year period at a tertiary referral center. Symptom burden was assessed by questionnaires to determine dominant symptom intensity (DSI; product of symptom severity, and frequency, on 5-point Likert scales) and global symptom severity (GSS; global esophageal symptoms on 10-cm visual analog scales) at the time of esophageal testing; BMIs were recorded. We compared proportions of patients with EMD and abnormal reflux burden among BMI categories and correlated them with symptom burden.
resultsFour-hundred thirty-three patients (39.8%) met the criteria for EMD. Esophageal outflow obstruction was observed in higher proportions of patients with low BMIs (underweight, 25.9%; normal, 14.1%; overweight, 13.9%; and obese, 9.8%; P = .037), but EMDs were less frequent in obese patients (P = .047), despite higher symptom burden compared with non-obese patients (DSI, 10.5 ± 0.3 vs 9.7 ± 0.2; P = .03 and GSS, 6.5 ± 1 vs 5.9 ± 1; P = .01). Among the 426 patients who underwent reflux monitoring, the proportions with total AET (P = .02), and upright AET (P < .001) increased among BMI categories, supine AET trended strongly (P = .06), in combination with increasing DSI and GSS (P ≤ .001 for each comparison). BMI correlated with symptom burden, higher AET, and positive symptom association probability (P < .01 for each analysis).
conclusionsIncreased symptom burden in obese individuals correlates with esophageal acid burden but not with motor disorders.
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