Impact of obesity on severity of esophageal reflux in gastroesophageal reflux disease measured by pH-Meter impedance

The prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide, and it is correlated with obesity. To ascertain if there is an association between obesity and severity of esophageal reflux, GERD must be diagnosed with greater precision and accuracy. Further, no studies have specifically examined the relationship between obesity and severity of esophageal reflux in patients with GERD. This study aimed to assess the impact of obesity on severity of esophageal reflux in GERD patients. This cross-sectional study was conducted from August to October 2017, and we enrolled GERD patients from Jakarta. Using consecutive sampling, 98 GERD patients were recruited and divided into two groups: (1) patients with body mass index (BMI) ≥ 25 kg/m² (obese, n = 49) and (2) patients with BMI 18.5-23.5 kg/m² (normal, n = 49). Upper gastrointestinal endoscopy was performed to assess hiatal hernia and erosive esophagitis. All patients underwent multichannel intraluminal impedance pH-meter (MII-pH) monitoring for quantification of the DeMeester score and acid exposure time. The results were analyzed using bivariate analysis. The DeMeester scores were significantly different between the obese and normal groups (166.65; p < 0.05). Bivariate analysis showed a significant difference between the two groups in terms of acid exposure time (p < 0.05; Relative Risk (RR) = 6.12 (3.25-11.54); CI 95%) and incidences of hiatal hernia (p < 0.05; RR = 7; 95% CI, 3.28-14.94) and erosive esophagitis (p < 0.05; RR = 4.5; 95% CI, 2.57-7.87). Obese patients had a higher DeMeester score than the normal BMI patients, along with greater risk of prolonged acid exposure time, hiatal hernia, and erosive esophagitis.