Why does obesity cause gastroesophageal reflux?
Obesity can cause or worsen gastroesophageal reflux through the following mechanisms:
Increased intra-abdominal pressure: Excess fat, especially visceral fat, increases intra-abdominal pressure. This pressure can push the stomach upward, causing a hiatal hernia and weakening the lower esophageal sphincter (LES), making it easier for acid to reflux into the esophagus.
Weakened lower esophageal sphincter: In obese people, pressure from increased abdominal fat can cause the LES to relax and weaken, leading to a reduced ability to prevent reflux.
Increased stomach acid production: Obese people tend to produce more stomach acid, contributing to the risk of reflux.
Hiatal hernia: The incidence of hiatal hernia is higher in obese people, and this further increases the risk of reflux.
Changes in digestion: Obesity can slow down digestion, causing slow stomach emptying (gastroparesis).
Reflux prevalence among obese patients
According to Associate Professor, Dr. Nguyen Anh Tuan - Deputy Director of the Institute of Digestive Surgery, Head of the Department of Digestive Surgery, 108 Central Military Hospital, said: "The rate of GERD in obese people is significantly higher than in the general population. Research shows that about 50 - 70% of obese people have symptoms of GERD. The risk of GERD increases with the level of obesity; people with higher BMI have a higher risk of GERD and related complications."
Treatment of gastroesophageal reflux in obese patients includes the following methods:
+ Weight loss: Weight loss is the most important and effective method in reducing reflux symptoms in obese patients. Weight loss can help reduce intra-abdominal pressure and improve LES function.
+ Diet: Avoid foods that can cause reflux such as fatty foods, fried foods, chocolate, caffeine, alcohol and spicy foods. Eat small meals, avoid overeating and do not lie down immediately after eating.
+ Exercise: Regular exercise helps you lose weight and improve digestion, but avoid exercises that increase pressure in the abdomen (such as bending over or lifting heavy weights).
When obesity is cured, will reflux be cured?
Not always completely cured: Although many patients experience significant improvement after weight loss, not everyone experiences complete cure. Some cases of reflux may persist, especially if there are other factors such as a hiatal hernia, severe weakness of the LES, or previous damage to the esophageal lining.
Obesity treatment is an important part of GERD management in obese individuals and can have positive results in reducing reflux symptoms, but results may vary from patient to patient.
