Study on The Symptoms and Esophageal Motility Characteristics of Gastroesophageal Reflux Disease Patients with Obesity

Background: Previous studies have shown that obesity affects the occurrence and development of GERD, GERD is also one of the many complications of obesity. However, few prior studies have evaluated the symptoms and esophageal motility characteristics of GERD patients with obesity. The purpose of this study was to assess the symptoms and esophageal motility characteristics of gastroesophageal reflux disease (GERD) patients with obesity and the relationship between symptoms and esophageal motility results. Methods: We conducted a retrospective study. Patients were divided into four groups according to whether diagnosed with GERD and obesity: obese GERD group (N=25), obese non-GERD group (N=21), non-obese GERD group (N=29), non-obese non-GERD group (N=22). High resolution manometry (HRM) was performed to assess esophageal motility. Gastroesophageal reflux symptoms were in accordance with the GERD questionnaire (GerdQ). Results: a) The main symptoms of obese GERD group were: reflux, upper stomach pain, nausea; in the non-obese GERD group were: reflux, heartburn and taking additional medication. b) The LES resting pressure in obese GERD group was lower than in non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The EGJ separation distance in obese GERD group was larger compared with non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The length of the esophagus in obese GERD group was shorter than in non-obese non-GERD group, non-obese GERD group and obese non-GERD group ( P <0.05); The DCI in obese GERD group was lower than in obese non-GERD group ( P <0.05). c) In obese GERD group, patients with reduced LES resting pressure or increased EGJ separation distance are more likely to have "reflux" symptoms. Conclusions: Comparing with GERD patients without obesity, the symptoms, esophageal motility, esophageal motility mechanism related to the symptoms of GERD patients with obesity got different characteristics. This result provides a reference for treatment options of GERD patients with obesity.