Gut Liver.  2018 Nov;12(6):633-640. 10.5009/gnl18148.

Weight Loss as a Nonpharmacologic Strategy for Erosive Esophagitis: A 5-Year Follow-up Study

• Bang KB
• Park JH

• KMID: 2427453
• DOI: http://doi.org/10.5009/gnl18148

Abstract

BACKGROUND/AIMS
Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE.
METHODS
A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution.
RESULTS
Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ≤1, 1-2, and >2 kg/m2, respectively.
CONCLUSIONS
EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

Keyword

Gastroesophageal reflux; Body mass index; Erosive esophagitis; Weight loss

MeSH Terms

Body Mass Index
Cohort Studies
Endoscopy
Esophagitis*
Follow-Up Studies*
Gastroesophageal Reflux
Logistic Models
Obesity
Odds Ratio
Proportional Hazards Models
Retrospective Studies
Risk Factors
Weight Loss*