Original articleAlimentary tractNonlinear Relationship Between Body Mass Index and Esophageal Acid Exposure in the Extraesophageal Manifestations of Reflux
Section snippets
Materials and Methods
The study was performed in accordance with the Declaration of Helsinki, and good clinical practice and applicable regulatory requirements. The Vanderbilt Institutional Review Board approved this clinical trial (IRB #090814).
Demographics and Body Mass Index Distribution
The study population consisted of 223 patients (median age, 53 y; interquartile range [IQR], 42–61 y; 76% female; 91% Caucasian; median BMI, 28; IQR, 24–32). The primary symptom complaints included the following: cough (52%), asthma (19%), hoarseness (15%), sore throat (6%), sinusitis/rhinitis (5%), and globus (3%). A secondary complaint of heartburn and/or regurgitation was present in 40% of patients. Hiatal hernia was present in 28% of patients (80% with <2 cm). Esophagitis was present in 15%
Discussion
This study objectively assessed the relationship between BMI and GERD in patients suspected of having extraesophageal manifestations of reflux. Similar to prior reports in patients with typical GERD,7, 8, 10, 20, 21 we found that esophageal acid exposure increased significantly with increasing BMI as a continuous as well as categoric variable. However, our data suggest that the increase in acid exposure per unit increase in BMI is not linear, unlike as previously reported in typical GERD. The
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Conflicts of interest The authors disclose no conflicts.