Comprehensive assessment of risk and development of gastroesophageal reflux disease associated with obesity
Т.M. Semikina1, М.А. Kunitsyna1, Е.I. Kashkina1, Е.V. Zhukova1
1Saratov State Medical University n.a. V.I. Razumovsky, 112 Bolshaya Kazachya Str., 410012 Saratov, Russian Federation
Kunitsyna M.A. — Doc. Med. Sc., Professor of the Department of Hospital Therapy of the Faculty of General Medicine, e-mail: [email protected]
Kashkina E.I. — Doc. Med. Sc., Professor of the Department of Hospital Therapy of the Faculty of General Medicine, e-mail: [email protected]
Semikina T.M. — applicant of the Department of Hospital Therapy of the Faculty of General Medicine, e-mail: [email protected]
Zhukova E.V. — applicant of the Department of Hospital Therapy of the Faculty of General Medicine, e-mail: [email protected]
The article was submitted on: 03 March 2018, accepted for publication on: 13 April 2018
The conducted study was focused on analyzing the role of obesity as a part of general risks of developing the GERD (gastroesophageal reflux disease), as well as the interaction between respiratory phases and the results of the 24 hour pH-metry under GERD. The study involved 101 patients with GERD and abdominal obesity, 97 patients with GERD without obesity and 82 patients of various body weights without GERD. The mean age of the examined people was 38.6 ± 4.6 years. For all of them, X-ray and esophagogastroduodenoscopy data and the body mass index (BMI) were examined. In 46 patients, 24-hour esophagus pH-metry and respiratory phases were analyzed. The 24-hour pH-metry was performed with acid-gas monitor AGM-24MP Gastroscan-24. The external respiration function was studied with Reakor complex manufactured by Medicom MTD (the town of Taganrog), during a 10-minute time interval. The statistical analysis was carried out using the standard Microsoft/Excel 2010 software. The arithmetic mean (M) and the arithmetic mean error (m) were determined. The reliability was determined by applying the Student’s t-test. The interaction between the quantitative indicators was determined by applying Spearman’s approach (r).
The study results showed that the risk of developing GERD in a particular person with obesity is conditioned not only by the degree of its severity, but also by the presence of risk factors. The correlation analysis showed that in obese patients the number of reliable dependences between the respiratory phases and the 24-hour pH-metry results is four times higher than in individuals with normal body weight, which points to an associative and possibly pathogenetic relationship between the change in respiration in the case of obesity and GERD development.
Key words: obesity, gastroesophageal reflux disease.
(For citation: Semikina Т.M., Kunitsyna М.А., Kashkina Е.I., Zhukova Е.V. Comprehensive assessment of risk and development of gastroesophageal reflux disease associated with obesity. Practical Medicine. 2018)
REFERENCES
- Starostin B.D. Gastroesophageal reflux disease (part I). Epidemiology, risk factors. Gastroenterology, 2014, no. 1, pp. 2-14. (in Russ.)
- Brilliantino A., Monaco L., Schettino V. et al. Prevalence of pathological duodenogastric reflux and the relationship between duodenogastric and duodenogastrooesophageal reflux in chroniс gastrooesophageal reflux disease. Eur J Gastroenterol Hepatol, 2008, vol. 20, no. 12. pp.1136—1143.
- Кaibysheva V.O., Stronova О.А., Trukhmanov А.S., Ivashkin V.Т. Intraesophageal pН-impedance measurement in the diagnosis of GERD. journal. Gastroenterol., hepatol., coloproctal, 2013, no. 2, pp.4-12. (in Russ.)
- Ivashkin V.T., Тruhmanov А.С., Sheptulin А.А. Gastroesophageal reflux disease. Recommendations for diagnosis and treatment, 2013, 20 p. (in Russ.)
- Ivashkin V.Т., Trukhmanov А.S. Evolution of ideas about the role of disorders of the motor function of the esophagus in the pathogenesis of gastrooesophageal reflux disease. journal. Gastroenterol., hepatol., coloproctal., 2010, vol. 20, no. 2, pp.13-9. (in Russ.)
- Yadlapati R., Craft J., Adkins C.J., Pandolfino J.E. The upper esophageal sphincter assist device is associated with symptom response in reflux associated laryngeal symptoms. Clin Gastroenterol Hepatol, 2018 Jan. Doi: 10.1016/j.cgh.2018.01.031. Pubmed PMID: 29408.
- Savarino E., Zentilin P. , Marabotto E. et al. Overweight is a risk factor for both erosive and non-erosive reflux disease. Digest Liver Dis 2011, vol. 43, no. 12, pp. 940—945.
- Wu J.C., Mui L.M., Cheung C.M., Chan Y., Sung J.J. Obesity is associated with increased transient lower esophageal sphincter relaxation. Digestion, 2007, vol. 132, no. 3, pp. 883-9.
- Maev I.V. Gastroesophageal reflux disease: from pathogenesis to therapeutic aspects. Consilium medicum, 2013, vol. 15, no. 8, pp. 30-4. (in Russ.)
- Wu J.C., Mui L.M., Cheung C.M., Chan Y., Sung J.J. Obesity is associated with increased transient lower esophageal sphincter relaxation. Digestion 2007, vol. 132, no. 3, pp. 883-9.