Obesity and GERD

Abstract

Epidemiologic data have demonstrated that obesity is an important risk factor for the development of gastroesophageal reflux disease (GERD). There is also accumulating data that obesity is associated with complications related to longstanding reflux such as erosive esophagitis, Barrett esophagus, and esophageal adenocarcinoma. Central obesity, rather than body mass index, appears to be more closely associated with these complications. Surgical data are confounded by the concomitant repair of prevalent hiatal hernias in many patients.

Keywords: Adiponectin; Barrett esophagus; Gastroesophageal reflux disease; Leptin; Obesity; Waist-to-hip ratio.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

FIGURE 1

World map of obesity and GERD prevalence in select countries. The obesity prevalence coded by the color key. The percentages indicate the GERD prevalence. Data from Refs 2, , –.

FIGURE 2

Mechanism of increased abdominal obesity leading to Barrett's esophagus. The increased adipose tissue leads to increases in leptin and TNFα which have been linked to a higher risk of Barrett's. Increased adipose tissue has also been inversely linked with adiponectin levels which are protective for the development of Barrett's.

FIGURE 3

Summary of potential pathogenic mechanisms in the obese leading to GERD.