Effect of weight reduction on gastroesophageal reflux in obese subjects

A high body mass index (BMI) has been shown to be associated with an elevated
risk of gastroesophageal reflux disease (GERD). A specific dose-relationship
between increasing BMI and the prevalence of GERD has been demonstrated. Weight
loss, along with other life style advice, is often recommended as part of the
first-line management of gastroesophageal reflux. However, the beneficial
effect of weight reduction has not been demonstrated unequivocally.

The primary aim of this study is to assess the effect of weight loss in obese
subjects, brought about by non-surgical methods, on all types of
gastroesophageal reflux (gaseous, liquid and mixed, acid and nonacid), as
measured by ambulatory pH/impedance monitoring.
The secondary aim of the study is to investigate the effect of weight reduction
on reflux symptoms and on the mechanisms underlying reflux.

In a prospective study the subjects will undergo two assessments to investigate
the severity of their gastroesophageal reflux, reflux symptoms and the
mechanisms underlying reflux, once before the start of a weight reduction
program and once after a weight loss of at least 10% of their initial weight.

Participation in the study implies that the patient has to travel to the UMC
Utrecht. At the start of the study and after a weight loss of 10% their
gastroesophageal reflux will be assessed with 3-hour stationary esophageal
manometry 24 hour pH-metry. The risk associated with these procedures is nil.
Careful assessment of reflux might lead to more appropriate therapy than
otherwise offered.