Gastro-esophageal reflux disease and Obesity, where is the link?

The confluence between the increased prevalence ofgastro-esophageal reflux disease (GERD) and of obesityhas generated great interest in the associationbetween these two conditions. Several studies haveaddressed the potential relationship between GERDand obesity, but the exact mechanism by which obesitycauses reflux disease still remains to be clearlydefined. A commonly suggested pathogenetic pathwayis the increased abdominal pressure which relaxes thelower esophageal sphincter (LES), thus exposing theesophageal mucosal to gastric content. Apart from themechanical pressure, visceral fat is metabolically activeand it has been strongly associated with serum levelsof adipo-cytokines including interleukin-6 and tumornecrosis factor α, which may play a role in GERD orconsequent carcinogenesis. This summary is aimed toexplore the potential mechanisms responsible for theassociation between GERD and obesity, and to betterunderstand the possible role of weight loss as a therapeuticapproach for GERD.