Obese Kids Have More Reflux Disease

Study: Childhood Obesity Raises GERD Risk by 30% to 40%

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

July 9, 2010 -- Obesity is a major contributor to acid reflux disease in adults, and it appears the same is true in children.

Obese children had a 30% to 40% higher risk of having acid reflux disease than normal-weight children in a new study conducted by researchers with the health management group Kaiser Permanente.

It is among the largest studies to examine the impact of obesity on acid reflux disease in children.

"Childhood obesity is an extremely serious issue," Kaiser research scientist Corinna Koebnick, PhD, tells WebMD. "Our study adds yet another risk to the already extensive list of risks associated with extreme obesity in childhood."

Kids, Obesity, and GERD

Known medically as gastroesophageal reflux disease, or GERD, the condition occurs when stomach contents back up into the esophagus. GERD can damage the esophagus and increase risk for esophageal cancer in adults.

Childhood obesity has more than tripled in the U.S. over the past three decades, according to the CDC.

These days, about one in five children and teens are obese, compared to about one in 20 three decades ago. As a result, obesity-related conditions such as high blood pressure and cholesterol, type 2 diabetes, and sleep apnea are all on the rise among children and teens.

Eight percent to 25% of children have frequent symptoms of reflux disease, Koebnick says. But the impact of the childhood obesity epidemic on the condition has not been well understood.

In an effort to address this, Koebnick and colleagues analyzed the electronic medical records of more than 690,000 children and teens enrolled in the Kaiser Permanente Southern California health plan in 2007 and 2008.

They found that in children aged 6 and older and in teens, but not in younger children, moderate and extreme obesity was associated with a statistically significant increase in reflux disease risk.

Reflux disease is common among infants, but obesity is not believed to play a role in infant GERD. The latest findings suggest that obesity is also not a major contributor to acid reflux disease in children younger than 6.

In older children and in teens, extreme obesity was associated with up to a 40% increase in GERD risk and moderate obesity was associated with up to a 30% increase in risk.

Risk Could Include Early Esophageal Cancer

In a separate study published last May, researcher Marek Lukacik, MD, and colleagues reported that overweight and obese children are 5-10 times more likely to have symptoms of GERD than children whose weight is normal.

Between 25% and 30% of the overweight children in the study had acid reflux symptoms.

Lukacik tells WebMD that he has seen a dramatic increase in GERD cases among children in recent years as a pediatric GI specialist at the Medical College of Georgia in Augusta.

"When I see an obese patient with other complaints, I ask about GERD symptoms and they frequently have them," he says.

He worries that early-onset GERD may make people vulnerable to esophageal cancer much earlier in life.

Cases of esophageal cancer are expected to double in the U.S. over the next two decades, making it the fastest-growing cancer nationwide. Obesity and GERD are major risk factors for the cancer.

"Adults with GERD may get esophageal cancer at 70, but a 10-year-old with GERD may be at risk much sooner," he says. "We can't say with certainty, but we do know that the longer someone has GERD the more damage is done to the esophagus."

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SOURCES: Koebnick, C. International Journal of Pediatric Obesity, 2010; online edition.

Corinna Koebnick, PhD, research scientist, Kaiser Permanente Southern California, Pasadena, Calif.

Marek Lukacik, MD, Medical College of Georgia, Albany.

News release, Kaiser Permanente.

CDC: Childhood Obesity, DASH Healthy Youth.

Digestive Disease Week 2010, New Orleans, May 1-6, 2010.

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