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A double whammy –obesity and GERD

August 15, 2012 6:52 am

“A double whammy is when something causes two problems at the same time, or when two setbacks occur at the same time.” Double whammy – Idiom Definition – UsingEnglish.com

Obesity probably doesn’t fit this definition strictly because it causes a lot more than two setbacks. However, obesity clearly causes its own set of problems and, even in childhood, contributes to the development of gastroesophageal reflux disease (GERD) (JPGN 2012; 55: 72-75).

This study consisted of 153 healthy children from a well-child clinic; among this group 31 were obese and 122 were nonobese. All caregivers completed a reflux questionnaire. The reflux symptomatic score was significantly higher in children with waist circumference (WC) >90th percentile compared with those <75th percentile. Furthermore, the rise in GERD symptoms (heartburn, epigastric pain, and regurgitation) was shown to rise progressively with increasing BMI and WC.

One of the shortcomings of the study was the use of a questionnaire that has not been validated for assessment of reflux symptoms in children (according to the authors, none are available in children); though, this questionnaire has been used in a few prior publications.

More references on GERD and obesity:

-Gastroenterology 2010; 139: 1902, 1823.. Abdominal visceral adipose tissue increases risk for Erosive esophagitis.
-Ann Intern Med 2005; 143: 199-211. Pooled studies showed GERD symptoms with ORs of 1.43 c BMI 25-30 & 1.94 for > 30. OR for esophagitis was 1.76 for BMI>25 & increased risk of adenoca of 1.68-2.02
-Gastroenterology 2006; 130: 1925-6. Obese youth have more reflux symptoms as with adults.

Previous post on GERD and asthma:

Treating reflux does not help asthma