体重指数和无法解释的慢性胃肠道症状:一项基于成年人群的内镜检查研究

摘要

Background: We aimed to determine whether obese subjects experience more gastro-oesophageal reflux (GORS) symptoms than normal subjects, and further to determine if this association was explained by oesophagitis or medications that lower oesophageal sphincter pressure. Methods: In a representative Swedish population , a random sample (n=1001, mean age 53.5 years, 51%women) had upper endoscopy. GORS was defined as any bothersome heartburn or acid regurgitation. Results: The prevalence of obesity (body mass index ≥30)was 16%; oesophagitis was significantly more prevalent in obesity (26.5%) than in normal subjects (9 .3%). There were associations between obesity and GORS (odds ratio (OR) 2.05 (9 5%confidence interval (CI) 1.39, 3.01)), epigastric pain (OR 1.63 (95%CI 1.05, 2.55)), irritable bowel symptoms (OR 1.58 (95%CI 1.05, 2.38)), any abdominal p ain (OR 1.59 (95%CI 1.08, 2.35)), vomiting (OR 3.11 (95%CI 1.18, 8.20)), retch ing (OR 1.74 (95%CI 1.1.3, 2.67)), diarrhoea (OR 2.2 (95%CI 1.38, 3.46)), any stool urgency (OR 1.60 (95%CI 1.04, 2.47)), nocturnal urgency (OR 2.57 (95%CI 1.33,4.98)), and incomplete rectal evacuation (OR 1.64 (95%CI 1.09, 2.47)), adj usting for age, sex, and education. When subjects with oesophagitis and peptic u lcer were excluded, only diarrhoea, incomplete evacuation, and vomiting were sig nificantly associated with obesity. The association between GORS and obesity rem ained significant adjusting for medication use (OR 1.9 (95%CI 1.3, 3.0)). Concl usions: GORS is associated with obesity; this appears to be explained by increas ed upper endoscopy findings in obesity.