PD06.07. The Impact of Obesity on EndoFlip Parameters in Adult Patients With GERD

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ID: 326140
2026
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Ranked #259 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Benign Disease: Gastro-Esophageal Reflux and Hiatal Hernia Background Obesity is a known risk factor for gastroesophageal reflux disease (GERD), but its effects on esophagogastric junction (EGJ) function remain unclear. EndoFLIP is used to assess EGJ distensibility index (EGJ-DI) and other esophageal parameters. This study investigates the relationship between obesity and EGJ-DI in adults with and without GERD. Methods A retrospective cohort study was conducted involving 86 adults (50 cases with GERD and 36 controls without GERD, confirmed negative by pH testing). GERD patients were defined as having either positive pH testing or objective evidence of GERD on endoscopy following Lyon Consensus 2.0 criteria. Obesity was categorized using BMI and further stratified into obesity classes I–III, with higher classes indicating greater body weight. Primary outcomes included EGJ-DI (mm2/mmHg) and EGJ distensibility category (normal, reduced, inconclusive). Secondary outcomes included maximum EGJ opening diameter and contractility patterns. EDJ-DI, EDJ opening diameter and contractility patterns were measured using EndoFlip. Patients with prior fundoplication, bariatric, or esophageal surgery were excluded from the study, as well as those diagnosed with major motility disorders, such as achalasia. Demographics, hiatal hernia presence, and PPI use were also recorded. Statistical analyses were performed using t-tests, chi-square tests, and ANCOVA, controlling for sex. Results The distribution of participants across BMI categories was as follows: 2 (2.3%) were underweight, 14 (16.3%) had normal weight, 23 (26.7%) were overweight, 26 (30.2%) were classified as Obesity Class 1 (BMI 30–34.9), 14 (16.3%) as Obesity Class 2 (BMI 35–39.9), and 7 (8.1%) were in Obesity Class 3 (BMI ≥ 40). When analyzing obesity within groups, no significant differences were found in EGJ-DI across BMI categories (p=0.16). The subgroup analysis showed no meaningful impact of obesity on secondary parameters, including EGJ opening diameter (p=0.12) and contractility patterns (p=0.10). In addition, the mean EGJ-DI did not significantly differ between GERD cases (4.3±2.0 mm2/mmHg) and controls (4.5±2.0 mm2/mmHg) (p=0.55). Conclusion Across BMI-defined obesity classes, no significant differences were observed in EGJ-DI, EGJ opening diameter, or contractility patterns as measured by EndoFLIP. These results imply that while obesity may contribute to GERD symptoms, it does not appear to affect EGJ mechanical function in a way that can be captured by EndoFLIP parameters. Further studies with larger sample sizes are needed to explore the potential role of obesity in EGJ dysfunction and GERD pathophysiology.
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Authors Jessica McClain, Yousif Esho, Julia Meguro, Joseph Chibueze, Anna Lipowska
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.119
URL
https://doi.org/10.1093/dote/doag077.119
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