The Correlation between Body mass Index and Esophagogastroduodenoscopic Finding in Patients with Dyspepsia

Due to its substantially increasing prevalence, obesity has become a worldwide concern. A tremendous number of studies existing nowadays highlighting the negative impacts of obesity on human health, however the potential role of obesity in gastrointestinal symptoms is unclear and, furthermore, inconsistent results reported from many studies. We, in this study, tried to answer the question whether obesity carry a higher risk for specific endoscopic diagnoses in patients with dyspepsia. This is a cross sectional study conducted at Sohar Hospital, Sultanate of Oman, on patients who complained from dyspepsia and referred as a candidate for esopagogastorduodenoscopy (EGD) due to either persistence of symptom, presence of alarming feature(s) or being more than 50 years. Clear definitions of obesity, dyspepsia, EGD findings and alarming features were made according to the general consensus. EGD was done to all patients who were included in the study for gross endoscopic abnormality as well as for Helicobacter pylori (H. pylori) infection. The endoscopic findings were analysed by the two the endoscopists independently. Among 118 participants, 61 were obese (51.8%) and 57 (48.2%) were non-obese. There were no statistical differences in term of patients’ gender and ethnicity. Eighty four (71.2%) patients presented with one of the alarming features. Weight loss, as a presentation, was particularly more common in obese patients (p < 0.001). Among all patients, 14 (11.9%) had normal EGD, majority were non obese (p < 0.033). For obese patients, the majority, 58 (95.1%), showed abnormal EGD findings (p < 0.001). A significant difference was observed between obese and non-obese patients presented with respect to hiatus hernia with esophagitis (p <0.001), gastritis with positive H. pylori (p = 0.046), gastritis with negative H. pylori (p = 0.021) and gastritis due to bile reflux (p = 0.002). Obese patients in our study showed a significantly higher abnormal EGD findings compared to non-obese. Bile reflux related gastritis represented the commonest abnormality. With these findings, EGD might be considered more frequently in obese patients who presented with dyspepsia for early diagnosis and treatment.