Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nearly all epidemiologic studies have found an association between increasing body mass index (BMI) and symptoms of gastroesophageal reflux disease (GERD). Changes in gastroesophageal anatomy and physiology caused by obesity may explain the association. These include an increased prevalence of esophageal motor disorders, diminished lower esophageal sphincter (LES) pressure, the development of a hiatal hernia, and increased intragastric pressure. Central adiposity may be the most important risk for the development of reflux and related complications such as Barrett's esophagus and esophageal adenocarcinoma. Weight loss, through caloric restriction and behavioral modification, has been studied infrequently as a means of improving reflux. Bariatric surgery and its effects on a number of obesity-related disorders have been studied more extensively. Roux-en-Y gastric bypass (RYGB) has been consistently associated with improvement in the symptoms and findings of GERD. The mechanism of action through which this surgery is successful at improving GERD may be independent of weight loss and needs further examination. Current evidence suggests that laparoscopic adjusted gastric banding should be avoided in these patients as the impact on gastroesophageal reflux disease appears unfavorable.
 ...
PMID:The association between gastroesophageal reflux disease and obesity. 1879 4

With the rising incidence and overall poor prognosis of esophageal adenocarcinoma (EA) there is great interest in furthering our understanding of Barrett's esophagus, the precursor lesion for most cases of EA. The best available evidence from true population-based analysis suggests that the prevalence of Barrett's is 1.6%. In addition, nearly half of the patients with Barrett's are asymptomatic. Several risk factors for development of Barrett's have been identified including gastro-esophageal reflux disease (GERD), central obesity, H. pylori eradication, and male gender. The precise incidence of progression from Barrett's to esophageal adenocarcinoma is not known, but it probably is less than 0.5% per year, and our ability to predict who is at highest risk for progression remains poor. The degree of dysplasia is currently used as a marker for risk of progression to cancer though there is increasing evidence that biomarkers and level of genetic instability may provide better predictive measures. Intensive acid-suppression and COX-2 inhibition are potential strategies to reduce the risk of progression, though definitive studies are needed. Endoscopic surveillance remains the mainstay of management for non-dysplastic and low grade dysplasia Barrett's. The advent of various endoscopic ablative therapies has provided a promising alternative to surgery for Barrett's patients with high grade dysplasia (HGD).
 ...
PMID:Barrett's esophagus in 2008: an update. 1885 65

Severe gastroesophageal reflux disease (GERD) predisposes to the development of Barrett's esophagus defined by the replacement of the squamous epithelium of the distal esophagus by a columnar epithelium. Barrett's esophagus is a precancerous condition which has a risk of malignant transformation to adenocarcinoma. Barrett's adenocarcinoma remains a relatively rare condition. Its incidence among patients followed up for Barrett's esophagus is approximately 0.5% patients per year. Besides GERD, obesity, male gender and age are the main risk factors for the development of Barrett's mucosa and esophageal adenocarcinoma. Men above 50 presenting with ancient and frequent GERD symptoms could benefit from an upper-GI endoscopy to detect Barrett's esophagus. Though still controversial, surveillance of Barrett's mucosa could allow detection of high grade dysplasia and esophageal adenocarcinoma at an early stage, enabling a curative treatment. Patients who cannot undergo surgery may be treated using endoscopic techniques such as endoscopic mucosal resection.
 ...
PMID:[Gastroesophageal reflux disease and malignancy]. 1892 21

Barrett's esophagus (BE) is one of the most common premalignant lesions and can progress to esophageal adenocarcinoma. It is characterized histologically by a specialized intestinal metaplasia that replaces the squamous epithelium of the distal esophagus, and is associated with chronic gastroesophageal reflux disease and obesity. Similar to the adenoma-carcinoma sequence of colorectal carcinomas, esophageal adenocarcinoma develops through progression from BE to low- and high-grade dysplasia, then to adenocarcinoma with accumulation of genetic and epigenetic abnormalities. The exact malignancy potential of BE is uncertain. Dysplasia is the most predictive marker for risk of esophageal adenocarcinoma, whereas endoscopic and histological diagnoses are still the gold standard for surveillance of patients with BE. However, both are limited, either by sampling errors in biopsies or by differences in histological interpretation. Several studies have identified candidate biomarkers that may have predictive value and may serve as additional factors for the risk assessment of esophageal adenocarcinoma. This review discusses the role of biomarkers in the progression from BE to adenocarcinoma, focusing on clinical and molecular markers.
 ...
PMID:Barrett's esophagus: can biomarkers predict progression to malignancy? 1907 43

We performed a systematic review and meta-analysis to study the association between elevated body mass index (BMI) and Barrett's esophagus (BE). Cross-sectional, case-control and cohort studies published through February 2008 that met strict inclusion and exclusion criteria were included. Summary estimates were calculated for the association between BE and being either overweight (BMI > or = 25 kg/m(2)) or obese (BMI > or = 30 kg/m(2)), or both. Based on 11 studies included in this analysis, there was a statistically significant relationship between increasing BMI and BE. Further studies are needed to evaluate if the presence of reflux attenuates the strength of this relationship, and if a particular pattern of obesity is more strongly associated with BE.
 ...
PMID:Exploring the association between elevated body mass index and Barrett's esophagus: a systematic review and meta-analysis. 1985 66

The complications of gastroesophageal reflux disease (GERD) include ulcers, strictures, Barrett's esophagus and carcinoma. Although the prevalence of GERD is very high, the development of complications remains quite rare and usually occurs in association with factors generally observed in more severe disease such as hiatal hernia, bile reflux or severely disturbed motility. Recent studies have emphasized the role of obesity and genetic factors as aggravating factors in the development of GERD complications. Barrett's esophagus is the most prevalent complication of GERD and seems to be associated with an increased mortality rate. However, cancer incidence is low and most patients die from other causes, especially cardiovascular disease.
 ...
PMID:Epidemiology of the complications of gastroesophageal reflux disease. 1943 54

The incidence of esophageal adenocarcinoma (EAC) has increased dramatically in the western world, and there also appears to have been an increase in the incidence of Barrett's esophagus and gastroesophageal reflux disease in recent years. The contemporaneous increase in obesity has focused interest on whether obesity is a risk factor for EAC and its precursors. This article reviews current evidence for the role that overweight/obesity and body fat distribution have in development of the esophagitis metaplasia-dysplasia-adenocarcinoma sequence. Particular attention is paid to the stage at which adiposity may act to influence the risk of EAC, because this determines the importance of weight control and weight loss at each stage in the disease spectrum for the prevention of EAC.
 ...
PMID:Role of obesity in Barrett's esophagus and cancer. 1950 Jul 35

The incidence of esophageal adenocarcinoma is increasing at a rate greater than that of any other cancer in the Western world today. Barrett's esophagus is a clearly recognized risk factor for the development of esophageal adenocarcinoma, but the overwhelming majority of patients with Barrett's esophagus will never develop esophageal cancer. To date, dysplasia remains the only factor useful for identifying patients at increased risk for the development of esophageal adenocarcinoma in clinical practice. Other epidemiologic risk factors include aging, gender, race, obesity, reflux symptoms, smoking, and diet. Factors that may protect against the development of adenocarcinoma include infection with Helicobacter pylori, a diet rich in fruits and vegetables, and consumption of aspirin and NSAIDs.
 ...
PMID:Risk factors for esophageal cancer development. 1950 Jul 37

Esophageal adenocarcinoma (EAC) has been rapidly increasing in Western countries during the past half century, especially in white men. Esophageal squamous cell carcinoma (ESCC) used to be the dominant type of esophageal malignancy both in Western and Asian countries. The rapid increase of EAC in Western countries has occurred in parallel with an increased prevalence of gastroesophageal reflux disease (GERD) and its major determinant, obesity. Such an increase in EAC has not yet been observed in Asia, despite a recent increase in prevalence of GERD. In this mini-review, we analyze possible factors influencing such east-west ('Orient to Occident') differences, particularly possible roles of ethnicity and environmental factors, such as Helicobacter pylori infection and nutritional factors, and how these might interact with socioeconomic differences. Development of Barrett's esophagus and esophageal adenocarcinoma appears to be strongly affected by ethnic factors, with populations resident at the west end of the Eurasian continent, such as Anglo-Celtics, being more prone to both conditions. On the other hand, ethnic groups from the eastern and southern ends of Eurasia, such as Chinese, Koreans and Japanese, and Africans might be more prone to developing esophageal squamous cell carcinoma. Future trends will also be discussed.
 ...
PMID:Epidemiology of esophageal cancer: Orient to Occident. Effects of chronology, geography and ethnicity. 1964 15

Gastroesophageal reflux is a well-recognized complication of obesity. Long-term reflux is associated with the progression from esophageal injury to Barrett's esophagus then to carcinoma. Bariatric surgery may prevent reflux and the progression of esophageal injury. We present two cases that had remission of their esophageal problems after differing bariatric operations.
 ...
PMID:Case reports--resolution of Barrett's disease and esophageal epithelial atypia after gastric bypass and LAP-BAND. 1975 86


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>