Multidisciplinary intervention reduces weight, acid suppression therapy use in GERD
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LAS VEGAS – Gastroenterologist and dietitian-led lifestyle intervention programs reduced weight and use of acid suppression therapy among patients with GERD, according to a presenter at ACG Annual Scientific Meeting.
“We know that incidence of GERD has been associated with excess body weight and obesity, and the proposed pathophysiology for this association includes a higher prevalence of functional impairment of the esophagogastric junction in these patients as well as higher abdominothoracic pressure grading,” Aiya Aboubakr, MD, of New York-Presbyterian/Weill Cornell Medical Center, said during a presentation. “In this context, weight loss is often recommended as part of lifestyle intervention for GERD, but the data are conflicting.”
In an ongoing, prospective cohort study, Aboubakr and colleagues analyzed the effect of a GI-based multidisciplinary weight-management program on acid suppression therapy among 66 patients with GERD (BMI > 25 kg/m2) who attended at least one follow-up visit to the Innovative Center for Nutrition and Gastroenterology weight-management clinic. Patients underwent anti-reflux diet and weight-loss counseling; researchers recorded data on acid suppression therapy, weight, BMI, the percentage of body fat and the percentage truncal adiposity of ideal measured by dual bioelectrical impendence at baseline and follow-up. Studied outcomes included therapy de-escalation or discontinuation and its correlation with weight and body composition. Researchers noted 69.9% of patients used acid suppression therapy at their initial study visit.
During 18 months of follow-up, 77.3% of patients experienced weight loss (median, 2.88 kg), 68.2% of patients experienced a decrease in BMI (median, 0.97 kg/m2) and 33.3% of patients lost greater than 5% of their total body weight. Among 30 patients who had available body composition markers, 73.3% had decreased percentage of body fat and decrease truncal fat percentage of ideal. Further, therapy discontinuation and de-escalation occurred in 30.5% and 15.2% of patients, respectively.
“The use of acid suppression therapy in patients with GERD can be significantly reduced through a GI-led multidisciplinary lifestyle intervention program; but our findings suggest that a patient's reduction in acid suppression therapy may be related to lifestyle and dietary changes or specific provider counseling rather than decreases in body weight or adiposity alone,” Aboubakr concluded. “Further studies are needed to assess the effects of absolute weight loss and body composition changes in patients with confirmed acid-mediated reflux disease.”
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Aboubakr A, et al. Gastroenterology-based multidisciplinary weight management program reduces acid suppression therapy in patients with GERD: A prospective cohort study. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
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