Extra Pounds Don't Affect Heartburn Rx

Non erosive reflux and erosive esophagitis success not dependent on body mass index

(RxWiki News) Overweight and obese patients are at risk for a number of health conditions, including​ heartburn and two kinds of acid reflux. Could their weight affect how well their medications treat those conditions?

In patients with erosive esophagitis (inflammation of the tube connecting the mouth and stomach), being overweight or obese did not affect whether the inflammation would heal while using certain over-the-counter medicines.

These research findings also showed that obesity did not affect how treatments worked in individuals with heartburn.

However, overweight individuals were more likely to have the condition in the first place.

"Keep your weight in check."

The aim of the study, led by Prateek Sharma, MD, from the Department of Gastroenterology at the University of Kansas School of Medicine in Kansas City, Missouri, was to see how obesity might affect symptoms in patients who had non-erosive reflux disease.

The condition is similar to gastro-esophageal reflux disease (GERD), in which stomach acid leaks upward into the esophagus and causes heartburn. Unlike GERD, non-erosive reflux does not damage the esophagus.

Another goal of the study was to see whether obesity affected healing rates in patients with erosive esophagitis, which damages the lining of the esophagus and causes swelling and inflammation.

Researchers did two different analyses and looked at previous studies already performed on patients.

The first analysis included 704 patients with non-erosive reflux disease. The patients were divided into one of three groups who received either 20 or 40 milligrams of esomeprazole (Nexium) or a fake pill.

The second analysis included more than 11,000 patients with erosive esophagitis. These patients received different doses of three over-the-counter heartburn medications, including omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium).

Researchers found that overweight and obese patients (BMI greater than 25) had significantly more severe and higher rates of erosive esophagitis before being treated than normal weight individuals.

At the same time, the severity of patients' non-erosive heartburn was not linked to their BMI before being treated, according to the researchers.

Concerning heartburn resolution, BMI did not predict whether heartburn would stop or that erosive esophagitis would heal during treatment.

"In conclusion, the findings of our study suggest that obese or overweight patients may be at a greater risk of advanced grades of [erosive esophagitis] than patients with normal weight," the researchers wrote in their report.

The researchers noted their study did not look specifically at the effects of obesity on acid reflux symptoms or treatment success since their study looked at previous studies.

In addition, they said that limited conclusions could be drawn concerning obesity's effect on a patient's response to other medicines, such as proton pump inhibitors that are available with a prescription.

Several of the authors received research funding from, served as consultants for and owned stock in several pharmaceutical companies related to the study. 

The study, funded by AstraZeneca, LP, and Wilmington, DE, was published February 24 in the Journal of Clinical Gastroenterology.

Review Date: 
March 16, 2013