The prevalence of obesity and overweight in the United States coupled by the increased risk of gastrointestinal diseases related to obesity raises serious implications for the health of Americans. Several scientific studies in the August issue of The American Journal of Gastroenterology examine the association between obesity and the risk of colorectal cancer and gastroesophageal reflux disease, or GERD.
Dr. Frank K. Friedenberg and colleagues from Temple University School of Medicine in Philadelphia provide an extensive overview of scientific research on the epidemiologic and pathophysiologic associations between obesity and GERD.
Several studies featured in the article highlight the correlation between increasing body mass index (BMI) and the frequency and severity of acid reflux symptoms. One particular study found that accumulation of abdominal fat, as measured by the waist-to-hip ratio, may be the most important risk factor for the development of acid reflux and related complications such as Barrett's esophagus and esophageal adenocarcinoma.
The authors also examined data on the effects of weight loss through diet or surgical methods on acid reflux disease. Several studies suggest weight loss through caloric restriction was beneficial in reducing GERD symptoms. When the authors compared the different surgical approaches for weight loss, a surgical technique called "Roux-en-Y" gastric bypass appeared to be the best method, and was most consistently associated with improvement in the symptoms and findings of GERD. "The mechanism of action through which this surgery is successful at improving GERD may be independent of weight loss and needs further examination," said Dr. Friedenberg.
Researchers at the University of Tokyo and Kameda General Hospital in Japan examined the effect of body weight on the incidence of colorectal adenoma in 7,963 Japanese patients who underwent colonoscopy between 1991 and 2003. Patients who had a family history of colorectal cancer, colorectal polyps, inflammatory bowel disease, colorectal surgery or who took NSAIDS were excluded from the study.