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Shahjehan A. Wajed, FRCS; Christopher G. Streets, MRCS; Cedric G. Bremner, MD; Tom R. DeMeester, MD

Arch Surg. 2001;136:1014-1019.

Hypothesis  Obesity impairs the antireflux function of a structurally intact barrier.

Design  Retrospective analysis of body mass index in patients with normal esophageal manometric findings but with symptomatic and objectively confirmed gastroesophageal reflux.

Setting  Specialist esophageal center.

Patients  Patients symptomatic and diagnostic for gastroesophageal reflux, referred between October 1, 1998, and June 30, 2000. Exclusion criteria were a defective barrier, motility disorders, or previous surgery.

Main Outcome Measures  Reflux was defined and quantified using the DeMeester score, and body mass index was calculated.

Results  There was a strong correlation between body mass index and severity of gastroesophageal reflux. Patients who were overweight had significantly higher distal esophageal acid exposure. No significant difference in manometric findings was demonstrated between patients with normal weight and those who were overweight.

Conclusion  The barrier to gastroesophageal reflux is rendered insufficient in patients who are overweight.

From the Department of Surgery, University of Southern California, Los Angeles.

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