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 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.
“Heartburn and acid regurgitation are very frequent, up to 30
percent 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 Dr. Eivind Ness-Jensen, the study’s senior
author.
GERD is defined as having “troublesome” symptoms of acid reflux -
where stomach acid flows back into the esophagus - or complications
of reflux at least once a week, the study team writes in the
American Journal of Gastroenterology.
Other symptoms include hoarseness, laryngitis, dry cough and
increased saliva. GERD can also eventually lead to precancerous
changes in the esophagus.
To see what characteristics predict development of GERD, 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 people 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
excess weight, based on body mass index (BMI), a measure of weight
relative to height. A BMI of less than 25 is considered normal, 26
to 29.9 is overweight or “pre-obese” and 30 or above is obese.
In the 12-year study, the risk of developing GERD rose by 30 percent
with every one-point increase in BMI, regardless of the person’s
starting BMI.
People who smoked cigarettes or had smoked previously were 29 to 37
percent 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.
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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.
“Obesity, especially abdominal obesity, increases the pressure on
the diaphragm and the muscles separating the esophagus from the
stomach, pushing acidic stomach content into the esophagus. Tobacco
smoking relaxes the muscles, facilitating reflux, and reduces the
production of saliva, which helps clean the esophagus,” he
explained.
Men were about 20 percent less likely to have GERD symptoms than
women. In addition, people with a higher education were about 30
percent less likely to develop GERD than people with less education.
Simply getting older also increased the risk of symptoms by 1
percent 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.
Fass said helpful web sites for people who want more information on
possible risk factors and symptoms of GERD are: http://www.gerdhelp.com/
and http://www.iffgd.org/.
SOURCE: http://bit.ly/1AGChqJ American Journal of Gastroenterology,
online February 10, 2015.
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