Predictive Value of Body Mass Index for Hiatus Hernia and Esophagitis in Gastroesophageal Reflux Disease Patients

Abstract

Objectives

Hiatus Hernia is one of the leading gastrointestinal problems in Pakistan. Despite the diagnostic challenges, obesity and increasing age are considered significant predictors of hiatus hernia. The study was conducted to establish the association between body mass index (BMI) and hiatus hernia and assess the predictive value of BMI in these patients.

Methods

During this descriptive case series 372 patients, presenting with GERD, underwent endoscopy using Olympus CLV-260 series gastroscope and findings were observed for hiatus hernia, grades of gastroesophageal flap valve (GEFV) according to Hill classification and stages of esophagitis according to Savary-Miller classification. BMI was calculated. Chi square test of independence for association between BMI & GEFV and a series of logistic regression analyses for predictive value of BMI were carried out during data analysis.

Results

The mean age of the patients was 48 years (SD=14.2). Normal BMI was most prevalent (36.3%) while grade II and III GEFV were the most common findings in 29.8% and 28.5% patients respectively. A chi square test of independence established that the association between BMI & GEFV was significant (p<.01) but no significant association was found between BMI and esophagitis (p=.14). A series of logistic regression analyses showed that BMI was not a significant predictor of hiatus hernia though age and gender were significant predictors.

Conclusion

BMI is not a significant predictor of hiatus hernia, grades of GEFV or esophagitis. However, further studies need to be conducted to establish stronger predictors for hiatus hernia and esophagitis.