TITLE:
Lack of correlation between obesity and gastroesophageal reflux disease (GERD) in a pediatric cohort
AUTHORS:
Simon S. Rabinowitz, Sridhar Goli, Jiliu Xu, Xuchen Zhang, Anthony Nicastri, Virginia Anderson, Dimitre G. Stefanov, Steven M. Schwarz
KEYWORDS:
Pediatric; GERD; Obesity; Endoscopy; Histopathology
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.3 No.4,
November
27,
2013
ABSTRACT:
Objectives: Previous reports correlating obesity
with gastroesophageal reflux disease (GERD) in children have yielded
conflicting results. This study examined whether increasing BMI (body mass
index) correlated with increasing grades of endoscopic and/or histopathologic
GERD in a cohort of inner city children. Designs and Methods: 340 consecutive
children (1 - 18 years) were classified as obese (BMI > 95%) for age and
gender. Both endoscopic findings and esophageal histopathology were
characterized by graded adult GERD scoring systems. Normal and abnormal grades
were then stratified based on BMI. Results: In the study cohort (mean age 10.5
± 4.7 yrs), 29% were obese (BMI > 95%) and 24% of the total cohort demonstrated
endoscopic features of GERD. With increasing severity of endoscopic GERD (from
normal to advanced), the percentage of obese patients at each grade did not
increase (Grade 0 = 30%, Grade 1 = 26%, Grades 2 - 4 = 30%). Histopathologic
findings consistent with GERD were noted in
21% of the total population studied. Again, the percentage of obese
children in each diagnostic category (Grades
0 - 3) did not increase with increasing severity of inflammation. Conclusions:
In this cohort of inner city children, obesity was not associated with
an increased prevalence of GERD as defined
by adult scoring systems.