Clinical and endoscopic study of dyspepsia in overweight and obese patients

Globally, the prevalence of obesity is increasing at an alarming rate. Obese patients often suffer from chronic dyspeptic symptoms. The aim of the study was to know the gross and histologic upper gastrointestinal mucosal changes and the prevalence of Helicobacter Pylori (H. Pylori) infection in overweight and obese dyspeptic patients.

A cross-sectional, observational study was done on 100 patients with dyspepsia and a body mass index (BMI) of ≥25 kg/m². The study was done between August 2019 and September 2021 at a tertiary care hospital in Maharashtra, India.

Chi-square test, Mann-Whitney test, and Fischer exact tests were applied to study the association between categorical variables. A P value of < 0.05 was considered statistically significant with a confidence level of 95%.

There were 59 males and 41 females. The mean age of the study subjects was 41.95 ± 12.32 years and the age range was 19-67 years. The maximum number of patients (36%) were in the age group of 50-59 years. Hypertension (45%) and type 2 diabetes mellitus (T2DM) (30%) were the common comorbidities present. Heartburn and regurgitation were the most common symptoms, present in 37% and 35% of the subjects, respectively. Inflammatory lesions oesophagitis (28%) and gastritis (43%) were the common findings in upper gastrointestinal endoscopy (UGIE). The stomach was the most common site with lesions. On histopathological examination, erosive gastritis (33%) and oesophagitis (28%) were confirmed. A total of 86% of obese subjects had at least one grossly abnormal finding. The prevalence of H. Pylori was 32%. Obese subjects had significantly more abnormal findings on UGIE compared to overweight subjects (P < 0.05). Obese patients suffering from type 2 diabetes mellitus had significantly abnormal findings on UGIE compared to non-diabetic obese patients (P < 0.05). Obese patients with higher body mass index (BMI) and the presence of H. Pylori infection were more likely to have abnormal UGIE findings.

Inflammatory and erosive lesions of the stomach and oesophagus are more common in obese dyspeptic patients. UGIE should be the investigation of choice and should be performed in overweight and obese patients with dyspepsia to predict and prevent Gastrointestinal (GI) disorders and their related complications.