Korean J Gastroenterol.  2024 Mar;83(3):81-86. 10.4166/kjg.2024.015.

Obesity and Upper Gastrointestinal Diseases

Affiliations
  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Obesity increases gastroesophageal reflux disease through several factors. As a result, Barrett's esophagus, esophageal adenocarcinoma, and gastroesophageal junctional gastric cancer are increasing. Existing studies usually defined obesity by body mass index and analyzed the correlation. Recently, more studies have shown that central obesity is a more important variable in upper gastrointestinal diseases related to gastroesophageal reflux. Studies have reported that weight loss is effective in reducing gastroesophageal reflux symptoms. Obesity also affects functional gastrointestinal diseases. A significant correlation was shown in upper abdominal pain, reflux, vomiting, and diarrhea rather than lower abdominal diseases.

Keyword

Adenocarcinoma of esophagus; Barrett esophagus; Body mass index; Gastroesophageal reflux disease; Obesity

Reference

1. Flegal KM, Carroll MD, Ogden CL, Johnson CL. 2002; Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 288:1723–1727. DOI: 10.1001/jama.288.14.1723. PMID: 12365955.
Article
2. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. 2006; Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 295:1549–1555. DOI: 10.1001/jama.295.13.1549. PMID: 16595758.
Article
3. 2023. 2023 Obesity fact sheet. [Internet]. Available from: https://cdn.medsoft.co.kr/kosso/2023_Obesity_Fact_sheet_web_kor.pdf. Korean Society for the Study of Obesity;Dec. 27. cited 2024 Mar 16.
4. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. 1999; Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 341:1097–1105. DOI: 10.1056/NEJM199910073411501. PMID: 10511607.
Article
5. Veugelers PJ, Porter GA, Guernsey DL, Casson AG. 2006; Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Dis Esophagus. 19:321–328. DOI: 10.1111/j.1442-2050.2006.00602.x. PMID: 16984526.
Article
6. Delgado-Aros S, Locke GR 3rd, Camilleri M, et al. 2004; Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol. 99:1801–1806. DOI: 10.1111/j.1572-0241.2004.30887.x. PMID: 15330922.
Article
7. Koerner A, Kratzsch J, Kiess W. 2005; Adipocytokines: leptin--the classical, resistin--the controversical, adiponectin--the promising, and more to come. Best Pract Res Clin Endocrinol Metab. 19:525–546. DOI: 10.1016/j.beem.2005.07.008. PMID: 16311215.
Article
8. Trayhurn P, Bing C, Wood IS. 2006; Adipose tissue and adipokines--energy regulation from the human perspective. J Nutr. 136(7 Suppl):1935S–1939S. DOI: 10.1093/jn/136.7.1935S. PMID: 16772463.
Article
9. Somasundar P, McFadden DW, Hileman SM, Vona-Davis L. 2004; Leptin is a growth factor in cancer. J Surg Res. 116:337–349. DOI: 10.1016/j.jss.2003.09.004. PMID: 15013374.
Article
10. Considine RV, Sinha MK, Heiman ML, et al. 1996; Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 334:292–295. DOI: 10.1056/NEJM199602013340503. PMID: 8532024.
Article
11. Zahorska-Markiewicz B, Janowska J, Olszanecka-Glinianowicz M, Zurakowski A. 2000; Serum concentrations of TNF-alpha and soluble TNF-alpha receptors in obesity. Int J Obes Relat Metab Disord. 24:1392–1395. DOI: 10.1038/sj.ijo.0801398. PMID: 11126333.
12. Kelesidis I, Kelesidis T, Mantzoros CS. 2006; Adiponectin and cancer: a systematic review. Br J Cancer. 94:1221–1225. DOI: 10.1038/sj.bjc.6603051. PMID: 16570048. PMCID: PMC2361397.
Article
13. Fried SK, Bunkin DA, Greenberg AS. 1998; Omental and subcutaneous adipose tissues of obese subjects release interleukin-6: depot difference and regulation by glucocorticoid. J Clin Endocrinol Metab. 83:847–850. DOI: 10.1210/jc.83.3.847. PMID: 9506738.
Article
14. Lee KJ. 2012; [Obesity and functional gastrointestinal disorders]. Korean J Gastroenterol. 59:1–7. Korean. DOI: 10.4166/kjg.2012.59.1.1. PMID: 22289948.
Article
15. El-Serag HB, Graham DY, Satia JA, Rabeneck L. 2005; Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 100:1243–1250. DOI: 10.1111/j.1572-0241.2005.41703.x. PMID: 15929752.
Article
16. Edelstein ZR, Farrow DC, Bronner MP, Rosen SN, Vaughan TL. 2007; Central adiposity and risk of Barrett's esophagus. Gastroenterology. 133:403–411. DOI: 10.1053/j.gastro.2007.05.026. PMID: 17681161.
Article
17. Cremonini F, Camilleri M, Clark MM, et al. 2009; Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study. Int J Obes (Lond). 33:342–353. DOI: 10.1038/ijo.2008.272. PMID: 19139750. PMCID: PMC2754813.
Article
18. Diaz-Rubio M, Moreno-Elola-Olaso C, Rey E, Locke GR 3rd, Rodriguez-Artalejo F. 2004; Symptoms of gastro-oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther. 19:95–105. DOI: 10.1046/j.1365-2036.2003.01769.x. PMID: 14687171.
Article
19. El-Serag HB, Kvapil P, Hacken-Bitar J, Kramer JR. 2005; Abdominal obesity and the risk of Barrett's esophagus. Am J Gastroenterol. 100:2151–2156. DOI: 10.1111/j.1572-0241.2005.00251.x. PMID: 16181362.
Article
20. Kang MS, Park DI, Oh SY, et al. 2007; Abdominal obesity is an independent risk factor for erosive esophagitis in a Korean population. J Gastroenterol Hepatol. 22:1656–1661. DOI: 10.1111/j.1440-1746.2006.04518.x. PMID: 17845694.
Article
21. Murray L, Johnston B, Lane A, et al. 2003; Relationship between body mass and gastro-oesophageal reflux symptoms: The Bristol Helicobacter Project. Int J Epidemiol. 32:645–650. DOI: 10.1093/ije/dyg108. PMID: 12913045.
Article
22. Nocon M, Labenz J, Willich SN. 2006; Lifestyle factors and symptoms of gastro-oesophageal reflux -- a population-based study. Aliment Pharmacol Ther. 23:169–174. DOI: 10.1111/j.1365-2036.2006.02727.x. PMID: 16393294.
Article
23. Rey E, Moreno-Elola-Olaso C, Artalejo FR, Locke GR 3rd, Diaz-Rubio M. 2006; Association between weight gain and symptoms of gastroesophageal reflux in the general population. Am J Gastroenterol. 101:229–233. DOI: 10.1111/j.1572-0241.2006.00412.x. PMID: 16454823.
Article
24. Stanghellini V. 1999; Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol Suppl. 231:20–28. DOI: 10.1080/003655299750025237. PMID: 10565620.
Article
25. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. 2003; Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA. 290:66–72. DOI: 10.1001/jama.290.1.66. PMID: 12837713.
Article
26. Hampel H, Abraham NS, El-Serag HB. 2005; Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 143:199–211. DOI: 10.7326/0003-4819-143-3-200508020-00006. PMID: 16061918.
Article
27. Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA Jr. 2006; Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 354:2340–2348. DOI: 10.1056/NEJMoa054391. PMID: 16738270. PMCID: PMC2782772.
Article
28. Nocon M, Labenz J, Jaspersen D, et al. 2007; Association of body mass index with heartburn, regurgitation and esophagitis: results of the Progression of Gastroesophageal Reflux Disease study. J Gastroenterol Hepatol. 22:1728–1731. DOI: 10.1111/j.1440-1746.2006.04549.x. PMID: 17914941.
Article
29. El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. 2007; Obesity increases oesophageal acid exposure. Gut. 56:749–755. DOI: 10.1136/gut.2006.100263. PMID: 17127706. PMCID: PMC1954847.
Article
30. Corley DA, Kubo A, Zhao W. 2007; Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms. Gut. 56:756–762. DOI: 10.1136/gut.2006.109413. PMID: 17047097. PMCID: PMC1954862.
Article
31. Ness-Jensen E, Lindam A, Lagergren J, Hveem K. 2013; Weight loss and reduction in gastroesophageal reflux. A prospective populationbased cohort study: the HUNT study. Am J Gastroenterol. 108:376–382. DOI: 10.1038/ajg.2012.466. PMID: 23358462.
Article
32. Singh M, Lee J, Gupta N, et al. 2013; Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity (Silver Spring). 21:284–290. DOI: 10.1002/oby.20279. PMID: 23532991. PMCID: PMC3853378.
Article
33. Kjellin A, Ramel S, Rössner S, Thor K. 1996; Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol. 31:1047–1051. DOI: 10.3109/00365529609036885. PMID: 8938895.
Article
34. Frederiksen SG, Johansson J, Johnsson F, Hedenbro J. 2000; Neither low-calorie diet nor vertical banded gastroplasty influence gastro-oesophageal reflux in morbidly obese patients. Eur J Surg. 166:296–300. DOI: 10.1080/110241500750009122. PMID: 10817325.
Article
35. Lagergren J, Bergström R, Nyrén O. 2000; No relation between body mass and gastro-oesophageal reflux symptoms in a Swedish population based study. Gut. 47:26–29. DOI: 10.1136/gut.47.1.26. PMID: 10861260. PMCID: PMC1727954.
Article
36. Park SK, Lee T, Yang HJ, et al. Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups. Neurogastroenterol Motil. 2017; May. doi: 10.1111/nmo.13009. DOI: 10.1111/nmo.13009. PMID: 28002892.
37. Jung HK, Tae CH, Song KH, et al. 2021; 2020 Seoul consensus on the diagnosis and management of gastroesophageal reflux disease. J Neurogastroenterol Motil. 27:453–481. DOI: 10.5056/jnm21077. PMID: 34642267. PMCID: PMC8521465.
38. Stein DJ, El-Serag HB, Kuczynski J, Kramer JR, Sampliner RE. 2005; The association of body mass index with Barrett's oesophagus. Aliment Pharmacol Ther. 22:1005–1010. DOI: 10.1111/j.1365-2036.2005.02674.x. PMID: 16268976.
Article
39. Jacobson BC, Chan AT, Giovannucci EL, Fuchs CS. 2009; Body mass index and Barrett's oesophagus in women. Gut. 58:1460–1466. DOI: 10.1136/gut.2008.174508. PMID: 19336423. PMCID: PMC2763036.
Article
40. El-Serag HB, Hashmi A, Garcia J, et al. 2014; Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett's oesophagus: a case-control study. Gut. 63:220–229. DOI: 10.1136/gutjnl-2012-304189. PMID: 23408348. PMCID: PMC3976427.
Article
41. Abnet CC, Freedman ND, Hollenbeck AR, Fraumeni JF Jr, Leitzmann M, Schatzkin A. 2008; A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma. Eur J Cancer. 44:465–471. DOI: 10.1016/j.ejca.2007.12.009. PMID: 18221867. PMCID: PMC2350215.
Article
42. Jansson C, Johansson AL, Bergdahl IA, et al. 2005; Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers. Cancer Causes Control. 16:755–764. DOI: 10.1007/s10552-005-1723-2. PMID: 16049815.
Article
43. Lukanova A, Björ O, Kaaks R, et al. 2006; Body mass index and cancer: results from the Northern Sweden Health and Disease Cohort. Int J Cancer. 118:458–466. DOI: 10.1002/ijc.21354. PMID: 16049963.
Article
44. Oh SW, Yoon YS, Shin SA. 2005; Effects of excess weight on cancer incidences depending on cancer sites and histologic findings among men: Korea National Health Insurance Corporation Study. J Clin Oncol. 23:4742–4754. DOI: 10.1200/JCO.2005.11.726. PMID: 16034050.
Article
45. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. 2007; Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 335:1134. DOI: 10.1136/bmj.39367.495995.AE. PMID: 17986716. PMCID: PMC2099519.
Article
46. Sjödahl K, Jia C, Vatten L, Nilsen T, Hveem K, Lagergren J. 2008; Body mass and physical activity and risk of gastric cancer in a population-based cohort study in Norway. Cancer Epidemiol Biomarkers Prev. 17:135–140. DOI: 10.1158/1055-9965.EPI-07-0704. PMID: 18187390.
Article
47. Hoyo C, Cook MB, Kamangar F, et al. 2012; Body mass index in relation to oesophageal and oesophagogastric junction adenocarcinomas: a pooled analysis from the International BEACON Consortium. Int J Epidemiol. 41:1706–1718. DOI: 10.1093/ije/dys176. PMID: 23148106. PMCID: PMC3535758.
Article
48. Kubo A, Corley DA. 2006; Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and metaanalysis. Cancer Epidemiol Biomarkers Prev. 15:872–878. DOI: 10.1158/1055-9965.EPI-05-0860. PMID: 16702363.
Article
49. Yang P, Zhou Y, Chen B, et al. 2009; Overweight, obesity and gastric cancer risk: results from a meta-analysis of cohort studies. Eur J Cancer. 45:2867–2873. DOI: 10.1016/j.ejca.2009.04.019. PMID: 19427197.
Article
50. Eslick GD. 2012; Gastrointestinal symptoms and obesity: a meta-analysis. Obes Rev. 13:469–479. DOI: 10.1111/j.1467-789X.2011.00969.x. PMID: 22188520.
Article
51. Eslick GD, Talley NJ. 2016; Prevalence and relationship between gastrointestinal symptoms among individuals of different body mass index: A population-based study. Obes Res Clin Pract. 10:143–150. DOI: 10.1016/j.orcp.2015.05.018. PMID: 26142872.
Article
Full Text Links
  • KJG
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr