Overweight and obesity are known risk factors for a variety of gastrointestinal disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), pancreatitis and GI cancer, hiatal hernias, indigestion, GERD, and gallstones. Obesity is recognized as a persistent state of chronic low-grade inflammation.
In addition to increased risk of GI disorders, obesity can negatively impact outcomes, and reduce response to treatment. Studies report that obesity affects the gut microbiome and is related to several conditions such as diverticulitis, and NAFLD (Non-alcoholic fatty liver disease).
GERD is recurrent symptoms of heartburn, and acid regurgitation, and impairs quality of life. Obesity increases abdominal pressure which causes the lower esophageal sphincter to relax allowing stomach contents to reflux into the esophagus. Repeated acid reflux can damage the lining of the esophagus and cause Barrett’s Esophagus and esophageal cancer. Weight loss is one of the few proven effective lifestyle modifications for GERD.
Hiatal Hernia is a risk factor for GERD. Obesity increases the risk of hiatal hernia. It occurs when the upper part of the stomach bulges through the diaphragm and causes acid reflux. Symptoms include heartburn, difficulty swallowing, coughing, nauseas, vomiting, breathing problems and stomach acid wears on the teeth.
Indigestion (Functional dyspepsia) is a functional disorder characterized by epigastric fullness and bloating, nausea, discomfort and vomiting provoked by eating food. It is common and can be a lifelong condition. If lifestyle changes don’t control it, treatment may include medication and behavioral therapy.
IBS is chronic abdominal pain and changes in bowel habits without a known cause. Symptoms include bloating, gas and diarrhea or constipation or both. It is a chronic condition that affects women more than men 2:1. It is associated with anxiety and depression.
This small, bulging pouches to develop in the digestive tract. These pouches can trap food and become inflamed or infected causing abdominal pain, bleeding, and intestinal blockage.
IBD affects 15-40% of overweight patients. Obesity is a risk factor for IBD. IBD is believed to be an immune disorder that can be inherited. IBD is characterized by inflammation of the lining of the digestive tract that over time damages the GI tract. It is term for two conditions – Crohn’s disease and ulcerative colitis. Crohn’s typically affects the small intestines and reaches deep into the walls of the GI tract. Ulcerative colitis occurs in the large intestines and rectum.
Symptoms of IBD include persistent diarrhea, abdominal pain, rectal bleeding, bloody stool, weight loss, and fatigue.
Pancreatitis is inflammation of the pancreas. Obesity increases pancreatitis via gall stones, high cholesterol, drugs, and weight loss interventions such as bariatric surgery. Symptoms of pancreatitis include upper abdominal pain, pain that radiates to the back, tenderness when touching the abdomen, fever rapid pulse, nausea, and vomiting.
Obesity impairs liver function and causes NAFLD which is driven by insulin resistance. NAFLD can progress to nonalcoholic steatohepatitis (NASH), hepatic fibrosis and cirrhosis. Diet and exercise are first line therapy, and the Mediterranean diet can promote weight loss and provide the appropriate nutrients and bioactive compounds that are anti-inflammatory.
Obesity is strongly associated with cancer of the digestive tract including cancer of the esophagus, stomach, liver, pancreas, and colon. It is also a strong risk factor for overall cancer mortality.
The evidence is clear, obesity not only increases the risk of GI diseases, but it is also associated with more severe disease and lower response to treatment leading to unfavorable outcomes.
Gastroenterology Associates of Brooklyn are committed to providing you with state-of-the-art care to help you achieve and maintain health. Contact us to schedule a consultation to learn how help.