International Journal of Epidemiology 2003;32:645-650
© International Epidemiological Association 2003
Relationship between body mass and gastro-oesophageal reflux symptoms: The Bristol Helicobacter Project
1 Dr Liam Murray, The Queen’s University of Belfast, Belfast BT12 5BJ, UK.
2 The Royal Group of Hospitals Trust. Grosvenor Road, Belfast BT12 6BJ, UK.
3 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
4 University of East Anglia, School of Health Policy and Practice, Norwich NR4 7TJ, UK.
5 Peterborough District Hospital, Thorpe Road, Peterborough PE3 6DA, UK.
6 Frenchay Hospital, North Bristol NHS Trust, Bristol BS16 1LE, UK.
Correspondence: Dr Liam Murray, The Queen’s University of Belfast, Mulhouse Building, The Royal Group of Hospitals, Grosvenor Road Road, Belfast BT12 6BJ, UK. E-mail: l.murray{at}qub.ac.uk
Objective To examine the relationship between body mass and gastro-oesophageal reflux in a large population-representative sample from the UK.
Design and setting Cross-sectional population-based study, as part of a randomized controlled trial of eradication of Helicobacter pylori infection, in Southwest England.
Subjects In all, 10 537 subjects, aged 20–59 years, were recruited from seven general practices. Subjects provided data on frequency and severity of dyspeptic symptoms and anthropometric measurements were taken.
Main outcome measure Relationship between overweight (body mass index [BMI] 
25 kg/m2 and 
30 kg/m2) or obesity (BMI >30 kg/m2) and frequency and severity of heartburn and acid regurgitation.
Results Body mass index was strongly positively related to the frequency of symptoms of gastro-oesophageal reflux. The adjusted odds ratios (OR) for frequency of heartburn and acid regurgitation occurring at least once a week in overweight participants compared with those of normal weight were 1.82 (95% CI: 1.33–2.50) and 1.50 (95% CI: 1.13–1.99) respectively. Corresponding OR (95% CI) relating to obese patients were 2.91 (95% CI: 2.07–4.08) and 2.23 (95% CI: 1.44–3.45) respectively. The OR for moderate to severe reflux symptoms were raised in overweight and obese subjects but not to the same extent as frequency of symptoms and only the relationship between obesity and severity of heartburn reached conventional statistical significance: OR = 1.19; 95% CI: 1.07–1.33.
Conclusions Being above normal weight substantially increases the likelihood of suffering from heartburn and acid regurgitation and obese people are almost three times as likely to experience these symptoms as those of normal weight.
Keywords Gastro-oesophageal reflux disease, heartburn, body mass index, obesity
Accepted 4 February 2003
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