Correlation of endoscopic severity of Gastroesophageal Reflux Disease (GERD) with Body Mass Index (BMI).

OBJECTIVE: To assess the correlation of endoscopic severity of Gastroesophageal Reflux Disease (GERD) with Body Mass Index (BMI).

DESIGN: Cross-sectional/analytical.

PLACE AND DURATION OF STUDY: Ghurki Trust Teaching Hospital and Surgimed Hospital, Lahore, from September 2004 to March 2006.

PATIENTS AND METHODS: This study was conducted on 203 patients, who presented with upper GI symptoms. Patients who fulfilled the symptom criteria were referred for endoscopy. Classification of GERD was done according to LA Grading classification system. Body mass index (BMI) was calculated as Body Weight (BW) in kilograms (kg) divided by the square of the body height (BH) in meter (m2). Patient data was analyzed using SPSS 12 software. Statistical evaluation was done using non-parametric Wilcoxon's-sign Rank test. P-value < 0.05 was considered to be statistically significant.

RESULTS: Distribution of GERD was as follows: GERD-A subjects 65 (32%), GERD B subjects 72 (35.4%), GERD-C subjects 23 (11.3%), GERD-D subjects 10 (4.92%), while Non-Erosive Reflux Disease (NERD) was present in 33 subjects (16.2%). Mean BMI was 27+/-5.02 SD (range of 18.2-38.3). BMI of patients having NERD was in normal range but patients who were having advanced disease i.e. Grade C-D were in obese range of BMI, while those who were having LA grade A-B were in overweight BMI range. When regrouped as mild GERD (grade A-B) and NERD versus severe GERD (grade C-D), there was a strong significant correlation between severity of GERD and BMI, as detected by Wilcoxon's signed Rank test (p=0.001).

CONCLUSION: Higher BMI seems to be associated with higher degree of endoscopic GERD severity.