Open AccessVoluntary and controlled weight loss can reduce symptoms and proton pump inhibitor use and dosage in patients with gastroesophageal reflux disease: a comparative study
Author(s) -
Bortoli N.,
Guidi G.,
Martinucci I.,
Savarino E.,
Imam H.,
Bertani L.,
Russo S.,
Franchi R.,
Macchia L.,
Furnari M.,
Ceccarelli L.,
Savarino V.,
Marchi S.
Publication year - 2014
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/dote.12319
Subject(s) - medicine , gerd , overweight , weight loss , reflux , proton pump inhibitor , gastroenterology , body mass index , obesity , reflux esophagitis , anthropometry , disease
Summary A wide variety of pieces of evidence has suggested that obesity is associated with a significant increase in the risk for gastroesophageal reflux disease ( GERD ) symptoms and its complications. The aim of this study was to evaluate the effect of weight loss on reflux symptoms in overweight/obese patients with proven GERD . We enrolled overweight/obese patients with typical GERD symptoms and erosive esophagitis. At baseline, patients underwent detailed reflux symptoms evaluation and anthropometric assessment, and were divided into two treatment groups: group A received proton pump inhibitor ( PPI ) and a personalized hypocaloric diet and aerobic exercise; and group B received PPI and a ‘standard of care diet’. The dietetic treatment was considered effective if at least 10% of weight loss was achieved within 6 months. All patients were evaluated in terms of anthropometric data, GERD symptoms, and PPI use. In group A , mean body mass index ( BMI ) decreased from 30.3 ± 4.1 to 25.7 ± 3.1 ( P < 0.05), and mean weight decreased from 82.1 ± 16.9 kg to 69.9 ± 14.4 kg ( P < 0.05). In group B , there was no change in BMI and weight. Symptom perception decreased ( P < 0.05) in both groups during PPI therapy, but a higher improvement was recorded in group A . In group A , PPI therapy was completely discontinued in 27/50 of the patients, and halved in 16/50. Only 7/50 continued the same PPI dosage. In group B , 22/51 halved the therapy and 29/51 maintained full dosage of therapy, but none was able to discontinue PPI due to a symptom recurrence. Overall, weight loss of at least 10% is recommended in all patients with GERD in order to boost the effect of PPI on reflux symptom relief and to reduce chronic medication use.