Prevalence of reflux esophagitis in obese Japanese undergoing bariatric surgery

Background: Currently, the data on the relationship between obesity and gastroesophageal reflux disease (GERD) in Asian populations are scarce.

Methods: The aim of this study is to investigate the prevalence of reflux esophagitis (RE) among obese Japanese patients in each body mass index (BMI) range group. In addition, we aim to investigate the risk factors for RE in obese Japanese patients. The present retrospective cohort study included 674 obese Japanese patients who underwent bariatric surgery between January 2003 and April 2016. The patients were stratified into five groups based on BMI range.

Results: The mean BMI was 42.7 ± 9.24 kg/m². The prevalence of RE among each of the groups was as follows: Group 1 (BMI 30-34.9) = 20.7%; Group 2 (BMI 35-39.9) = 24.0%; Group 3 (BMI 40-44.9) = 25.2%; Group 4 (BMI 45-49.9) = 26.7%; and Group 5 (BMI ≥50) = 24.8%. Overall, the prevalence of RE was 24.2% in our study. Furthermore, no significant difference in BMI was noted between the RE and non-RE groups (43.4 ± 9.3 kg/m² and 42.5 ± 10.2 kg/m², respectively; p = 0.24). According to the multivariate logistic regression model, gender, Helicobacter pylori infection status, GERD-related symptoms, and hiatal hernia were significantly correlated with RE.

Conclusion: Our study shows that the prevalence of RE in severely obese Japanese patients was significantly higher than the average prevalence of RE in Japan. However, the prevalence of RE did not increase with BMI in our cohort.

Keywords: bariatric surgery; gastroesophageal reflux disease; obesity.