Weight Management as a Treatment Option for Gastroesophageal Reflux Disease: A Mechanical or Metabolic Rescuer?
Abstract
Gastroesophageal reflux disease (GERD) is a multifactorial disease with both anatomical and functional factors involved in the pathogenesis. Although the basic understanding is that GERD is caused by increased relaxation of the transient lower esophageal sphincter accompanied by impaired lower esophageal sphincter basal tone or gastric or esophageal motor dysfunction, the exact pathogenesis of GERD is still not fully understood. In addition, environmental factors are considered as important risk factors for GERD, more specifically, being overweight/obese, inappropriate dietary habits, lack of regular physical activity, and smoking. Nonetheless, whether or not the improvements or changes in these lifestyle habits can lead to a protective beneficial effect against GERD remains unclear. American College of Gastroenterology guideline regarding the lifestyle interventions for GERD suggests that weight loss is an effective regimen for GERD symptom improvement and therefore is strongly recommended for patients with body mass index (BMI) >25 kg/m or with recent weight gain. Previous randomized controlled trials and prospective population-based cohort studies that assessed the effect of weight reduction for the management of GERD-related symptoms in obese subjects sometimes demonstrated beneficial effects, with normalization of pH measurements or dose-dependent decrease in symptom prevalence after weight loss. However, other studies suggested that weight loss has no effect on the…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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