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Risk Factors for Heartburn: Excess Weight, Smoking

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Here is a summary of a recently published article which is of interest to many of us :-

(Reuters Health) - Excess pounds and smoking might each raise the likelihood of frequent heartburn or gastroesophageal reflux disease (GERD), according to a large study from Norway.

Other factors linked to higher odds of new GERD symptoms included getting older, being a woman, having less education, and even quitting smoking - if it led to weight gain.

"Up to 30% of people in Western populations have these complaints at least weekly, so we wanted to know more about the reasons why these symptoms appear," said senior author Dr. Eivind Ness-Jensen.

For a February 10 online paper in the American Journal of Gastroenterology, the researchers analyzed data on nearly 30,000 people in Nord-Trondelag County, Norway.

Subjects were interviewed in 1995-1997 and again in 2006-2009.

They had no GERD symptoms in the first interview. By the second interview, 510 had severe GERD symptoms and 14,406 still had no GERD complaints. People with very mild or less than weekly symptoms were excluded from the comparison.

The researchers found a steady increase in GERD risk with greater body mass index (BMI). Over 12 years, the risk of developing GERD rose by 30% with every one-point increase in BMI, regardless of the person's starting BMI.

People who smoked cigarettes or had smoked previously were 29-37% more likely to develop GERD than never-smokers.

And those who stopped smoking but whose BMI rose more than 3.5 points after quitting were twice as likely to develop symptoms as people who had never smoked.

Ness-Jensen, a public health researcher at the Norwegian University of Science and Technology in Levanger, noted in an email that one of his previous studies showed quitting smoking reduced the risk of GERD symptoms, although the current study found that weight gain could take away that protection. "So, avoid weight gain when quitting smoking," he said.

Men were about 20% less likely to have GERD symptoms than women. In addition, people with a higher education were about 30% less likely to develop GERD than people with less education. Simply getting older also increased the risk of symptoms by 1% per year.

Dr. Ronnie Fass, chair of Gastroenterology and Hepatology at MetroHealth Medical Center in Cleveland, Ohio, said two of the study's unique findings were that men had a lower chance of getting GERD and that smoking could lead to symptoms.

"It has been established in the literature that males and females have the same risk of having GERD . . . As a result, this is very intriguing," said Fass, who was not involved in the study.

While past studies have linked smoking with GERD, this "is one of the first studies that, in fact, documented the role of smoking in causing new-onset GERD-related symptoms," said Fass.

SOURCE: bit.ly/1AGChqJ

Am J Gastroenterol 2015.

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Thank you very much for posting this.

The logic behind GORD and body weight is that the pressure of the weight in the abdomen tends to push stomach contents up past the lower oesophageal sphincter into the oesophagus where the lining cannot cope with the acid like the stomach lining can. Hence the problems faced by pregnant women. And smoking tends to relax the sphincter. Hiatus hernia can also be a factor because part of the stomach is by definition higher than the sphincter that is part of the diaphragm.

I think the author collaborates with Jesper Lagergren who is a very distinguished author in the field of associating heartburn, Barrett's oesophagus and oesophageal adenocarcinoma.

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