Overweight is a risk factor for both erosive and non-erosive reflux disease

Edoardo Savarino, Patrizia Zentilin, Elisa Marabotto, Daria Bonfanti, Simona Inferrera, Lorenzo Assandri, Giorgio Sammito, Lorenzo Gemignani, Manuele Furnari, Pietro Dulbecco, Vincenzo Savarino

Research output: Contribution to journalArticlepeer-review


Introduction: Studies have reported that the association between overweight and erosive oesophagitis is very strong, whilst seeming less consistent with non-erosive reflux disease. Aim: We have hypothesized that this difference may be due to the heterogeneity of endoscopy-negative population. Methods: We studied 81 patients with erosive oesophagitis, 48 controls and 295 endoscopy-negative patients classified by impedance-pH-testing as: (1) pH-POS (abnormal acid exposure); (2) hypersensitive oesophagus (normal acid exposure/SAP+); (3) functional heartburn (normal acid exposure/SAP-). Body mass index was also calculated. Results: Mean body mass index was significantly higher (p<0.05) in erosive oesophagitis than in endoscopy-negative patients as a whole and controls [27 (18-40) vs. 25 (16-48) vs. 23 (16-34)]. However, the separation of endoscopy-negative patients showed that mean body mass index was higher (p<0.05) in those with increased acid exposure time [26 (18-45)] than in hypersensitive oesophagus [24 (16-48)]. The former subgroup was similar to erosive oesophagitis, whilst the latter one to both functional heartburn [23 (16-34)] and controls (p= ns). Increased body mass index represented a risk factor for erosive oesophagitis (odds ratio 1.4; 95% confidence interval, 1.2-1.6) and non-erosive reflux disease pH-POS subgroup (odds ratio 1.35; 95% confidence interval, 1.2-1.5). Conclusion: Our study shows that overweight represents an important risk factor for erosive oesophagitis and pH-POS non-erosive reflux disease and not for hypersensitive oesophagus and functional heartburn. This provides an explanation for the previously reported lesser role of this variable in non-erosive reflux disease population.

Original languageEnglish
Pages (from-to)940-945
Number of pages6
JournalDigestive and Liver Disease
Issue number12
Publication statusPublished - Dec 2011


  • BMI
  • Impedance pH-metry
  • MII-pH
  • Non-acid reflux
  • Overweight

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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