Association of Gerd with Obesity & the Waist Circumference “A Reflux or Reflex Affair!

Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower oesophageal sphincter and causes injury to the oesophagus from chronic reflux exposure to stomach acid. Gastroesophageal reflux disease is one of the most common health problems in the world today. Up to 80% of the patients with reflux disease experience difficulty in sleeping, working and eating thereby contributing to an impaired quality of life. The financial burden of GERD Gastroesophageal reflux disease on the health sector is enormous. World wide GERD is increasingly and of late is being reported from Asia and south east Asian countries. The relationship of GERD with obesity is assumed but the evidence is equivocal. Substantial studies that report an association between the two and an equal number concluding that there is no association between GERD and obesity. In Malaysia Obesity is on the rise among its residents the Malay, the Chinese and among the Indian population. A cross sectional study was therefore conducted to establish an association if any between moderate & severe GERD versus Obesity and Waist circumference. Results: A total of one hundred and fifty five subjects had GERD, Among the one hundred and fifty five, 111 subjects were obese, only forty four had a normal body mass index. The Obese subjects in both the moderate and severe categories had varying grades of obesity I-III. The majority of the obese were among the Malay population. The Body mass index and waist circumference was noted to be higher than their Chinese counterparts. In this study five subjects were noted to have Non erosive reflux disease (NERD). A total of seventeen patients had Barrett oesophagus nine of whom were males. Interestingly the severity of the self reported Clinical symptoms in those patients with Barrett oesophagus was less. The current trend in the rise of obesity with its co morbidities and the increasing prevalence of gastroesophageal reflux disease is likely to impose huge financial costs that will impact economy of the health care sector of many developing nations including Malaysia in this part of the world. Conclusion: Obesity is on the rise worldwide as is witnessed in Malaysia. GERD and non erosive reflux disease is prevalent among the population in Kelantan. Body mass index and waist circumference were not found to be associated with the severity of GERD in both the moderate and severe categories.