Increased prevalence of gastroesophageal reflux symptoms in obese children evaluated in an academic medical center.

OBJECTIVE

To test the hypothesis that obese children are at higher risk of having gastroesophageal reflux symptoms compared with nonobese children.

METHODS

In this prospective study, 236 obese children (age: 7 to 16 y) were interviewed using a standard questionnaire for reflux symptoms and a reflux symptom score was calculated. Obesity was defined as body mass index (BMI) greater than 95th percentile for age and sex. One hundred and one age-matched and sex-matched children with BMI between 5th and 95th percentile served as controls. Demographic data were collected in all children. We compared prevalence rates of a reflux symptom score and other symptoms between the 2 groups.

RESULTS

A prevalence rate of a positive reflux symptom score (13.1%) was significantly higher in obese children than in the control group (2%) (odds ratio: 7.3, 95% CI: 1.7-31). Obesity remained as the only significant predictor for a positive reflux symptom score after controlling for other variables such as age, sex, race, and caffeine exposure (adjusted odds ratio: 7.4, 95% CI: 1.7-32.5). A positive reflux symptom score increased significantly from 2% in the control group to 11.7% in 196 obese children to 20% in 40 severely obese children (with BMI z-score >2.7).

CONCLUSIONS

Obese children (age: 7 to 16 y) are at higher risk of having reflux symptoms compared with the control group. This risk is independent of age, sex, or race and increases with higher BMI.