Relationship of Overweight to Hiatus Hernia and Reflux Oesophagitis

Stene-Larsen, G; Weberg, R.; Larsen, Ingegerd Frøyshov; Bjørtuft, Øystein; Hoel, Bjørn; Berstad, Arnold

doi:10.3109/00365528809093890

Cited by 146 publications

(76 citation statements)

References 8 publications

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“…This is different from some studies showing that adjustment for GERD causes the attenuation or disappearance of the effect of increased BMI on BE risk [9,52], but it agrees with other studies showing that this adjustment does not affect the association [40,49,53]. Although obesity is a well-recognized risk factor for GERD through mechanically induced reflux by enhancing the intra-abdominal pressure [54] or facilitating the formation of a hiatal hernia [55,56], a slightly overweight status with a BMI of 23.0-24.9 might be insufficient to provoke induced reflux. Supporting this, a recent study demonstrated that, although esophageal acid exposure increased significantly with increasing BMI, the most remarkable increase in acid reflux occurred in the BMI zone of 25-30 [57].…”

Section: Discussioncontrasting

confidence: 37%

Association between the Body Mass Index and the Risk of Barrett's Esophagus in Japan

Shinkai

Iijima²,

Koike³

et al. 2014

Digestion

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Background: We investigated the association between long-segment Barrett's esophagus and obesity in the Japanese population in a multicenter case-control trial. Methods: One hundred thirteen patients with endoscopically detected Barrett's esophagus with a length of more than 2 cm and the same number of sex- and age-matched controls were prospectively enrolled. Barrett's esophagus was diagnosed based on the Prague C and M criteria. The body mass index (BMI) of the subjects was categorized into the following groups: normal, BMI <22.9; overweight, BMI 23.0-24.9, and obese, BMI >25.0. To determine the association between BMI and the risk of Barrett's esophagus, multivariate logistic regression analyses were performed. Results: The basically adjusted regression model adjusted for smoking and alcohol consumption revealed that overweight and obesity were significantly associated with an elevated risk of Barrett's esophagus (OR 2.4, 95% CI 1.2-4.7, and OR 2.5, 95% CI 1.3-4.6, respectively). The intensity of the association was not attenuated even after adjustment for gastroesophageal reflux disease-related parameters. Conclusions: An increased BMI was associated with an increased risk for Barrett's esophagus through a gastroesophageal reflux-independent mechanism in the Japanese population. Further, unlike in Caucasian populations, being even slightly overweight with a BMI of 23.0-24.9 was an independent risk factor in the Japanese population.

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Section: Discussioncontrasting

confidence: 37%

Association between the Body Mass Index and the Risk of Barrett's Esophagus in Japan

Shinkai

Iijima²,

Koike³

et al. 2014

Digestion

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“…Our study is consistent with one study conducted by Arvind Kumar et al [42], indicated that there was significant association between 31 to 40 year age group and Dyspepsia. On the other hand, in studies conducted in Shiraz [14] and US [45], there was no relationship between age and Dyspepsia, while other studies found the positive and reverse associations between age and functional Dyspepsia, respectively [44,46].…”

Section: Discussionmentioning

confidence: 89%

Dyspepsia and Associated Risk Factors at Yirga Cheffe Primary Hospital, Southern Ethiopia

Ayele¹,

Molla²

2017

Clin Microbiol

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Dyspepsia is a common symptom of gastrointestinal disease with global distribution. The prevalence of this disorder varies between 3% and 40%. Dyspeptic symptoms account 10% of hospital admissions in Ethiopia. The aim of this study was to determine the contributing factors for dyspepsia at Yirga cheffe primary hospital, Southern Ethiopia.: A case control study design was conducted between July 6, 2016 and August 10, 2016 on a total of 168 patients at Yirga cheffe primary hospital, South Ethiopia. The Helicobacter pylori (H. pylori) stool antigen test was used to analyze the stool samples and a face to face interview was taken to assess other contributing factors for the infection. Ethical clearance and informed consents was obtained before data collection. Logistic regression analysis was used to estimate odds ratio (adjusted with 95% confidence interval) of positive responses to the different risk factors. Comparisons between groups were assessed with chi-square test and a P-value of <0.05 was considered statistically significant. Helicobacter pylori antigen was detected in 13 of the 168. Helicobacter pylori infection was six times more associated with dyspeptic patients than non-Dyspeptic individuals. Anxiety and depression was six and three times more likely associated with dyspepsia, respectively. Although dyspepsia was greater among male, and peaked in the age groups of 21-30 years old, the association was not statistically significant. Moreover, patients who consume foods containing peppercorn ("key wot") have high chance of developing Dyspepsia. Study subjects who depend on untapped drinking water sources, treating their drinking water, smoking habit, chewing khat, washing their hand with soap, and their toilet with flush tank were not significantly associated with dyspepsia (P>0.05). Thus, early diagnosis of H. pylori, psychological treatment of patients and food habit of the individuals should give attention to prevent and control Dyspepsia even though additional studies need to be conducted.

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“…The mechanisms by which obesity increases the risk of oesophageal adenocarcinoma remain open for discussion but may be linked to the predisposition of obese individuals to gastro-oesophageal reflux, hiatal hernia and consequent Barrett's oesophagus. [7][8][9][10][11]18,19 Obesity has increased in most developed countries and is gradually affecting developing countries as well. Central obesity, the type of obesity likely to be involved in the postulated pathogenic process, is particularly common among men, though no adequate information is available on type of obesity and oesophageal adenocarcinoma risk.…”

Section: The Hypothesismentioning

confidence: 99%

Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?

Vecchia

Negri

Λάγιου

et al. 2002

Intl Journal of Cancer

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Incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing in most developed countries and strongly associated with obesity and male gender. An underlying increase in the prevalence of gastro-oesophageal reflux has generally been postulated. We suggest that the increase in frequency of reflux and the 2 associated forms of cancer can be explained by growing abdominal pressure brought about by increasing central obesity, most common among men, and sedentary lifestyle, including car use. Abdominal pressure is further accentuated mainly in men by the shift in Western male dressing towards the general use of belts. © 2002 Wiley-Liss, Inc. Key words: oesophageal adenocarcinoma; carcinogenesis; riskA rising incidence of adenocarcinoma of the oesophagus and gastric cardia, mostly in males, has been reported for most developed countries. 1-5 These forms of cancer have been linked to gastro-oesophageal reflux in several studies. 6 -11 In addition to male gender, obesity has emerged as a major risk factor. [12][13][14] The alarming increase in the incidence of adenocarcinoma of the oesophagus and gastric cardia has triggered many studies focused on antiulcer drugs that were gradually introduced during the last 25 years, including H 2 receptor antagonists and proton pump inhibitors. These studies have been reviewed, 15 and no incriminating evidence against any of these drugs has emerged. In the absence of such evidence, an explanation for the increasing trend of adenocarcinoma of the oesophagus and gastric cardia should accommodate the 3 salient risk factors for this disease: obesity, male gender and the sharply increasing incidence in developed countries (with the exception of some central and western European registries) 16 -18 rather than in developing ones, 1-5 though data from the latter are limited. 5 THE HYPOTHESISWe postulate that the increasing frequency over time of gastro-oesophageal reflux and adenocarcinomas of the oesophagus and gastric cardia is due to growing abdominal pressure brought about by obesity, the sitting position and the constraining influence of tight belts. The mechanisms by which obesity increases the risk of oesophageal adenocarcinoma remain open for discussion but may be linked to the predisposition of obese individuals to gastro-oesophageal reflux, hiatal hernia and consequent Barrett's oesophagus. [7][8][9][10][11]18,19 Obesity has increased in most developed countries and is gradually affecting developing countries as well. Central obesity, the type of obesity likely to be involved in the postulated pathogenic process, is particularly common among men, though no adequate information is available on type of obesity and oesophageal adenocarcinoma risk. The sitting position characterises sedentary occupations as well as car transportation, both features that tend to increase with time and to be more frequent in economically developed countries. Lastly, belts, particularly among overweight men, have a constraining influence that did not exist in the past, when suspenders...

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Relationship of Overweight to Hiatus Hernia and Reflux Oesophagitis

Cited by 146 publications

References 8 publications

Association between the Body Mass Index and the Risk of Barrett's Esophagus in Japan

Association between the Body Mass Index and the Risk of Barrett's Esophagus in Japan

Dyspepsia and Associated Risk Factors at Yirga Cheffe Primary Hospital, Southern Ethiopia

Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?

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