Obesity related pathophysiological aspects favouring Gastroesophageal Reflux Disease

Abstract

Gastroesophageal reflux disease (GERD) is a complex entity and one of the most frequents in general population. Association of GERD with obesity is clearly defined from an epidemiological point of view, where up to 40% of patients with overweight and obesity present reflux. Most of the risk factors associated to GERD are shared and especially frequent in patients with obesity. The pathophysiology that explain this correlation is complex and multifactorial, and includes both aspects related to physiology of motility, and anatomic changes. The malfunction of the lower esophageal sphincter, the greater transdiaphragmatic pressure gradient, pathological accumulation of fat and the high rate of hiatal hernia that comes with overweight will be the main factors that explain this correlation. Other factor like pathological eating habits or obesity related diseases have also an important role. In summary, it is the sum of the factors more than just one of them what would explain the pathophysiology of GERD in obese population.

Keywords: Esfínter esofágico inferior; Esophageal motility; Gradiente transdiafragmático; Hernia de hiato; Hiatal hernia; Lower esophageal sphincter; Motilidad esofágica; Obesidad; Obesity; Reflujo; Reflux; Transdiaphragmatic gradient.