Impact of Body Mass Index on Gastrointestinal Disorders: A Cross-sectional Study in a Pakistani Population

Background: The prevalence of obesity is on the rise globally. Pakistan ranks ninth out of 188 countries in terms of obesity. Literature regarding any potential role of obesity in gastrointestinal manifestations is limited. Besides, scarce information is available on possible connection between obesity and gastrointestinal pathology. This research, therefore, explores the impact of body mass index (BMI) on gastrointestinal symptoms and endoscopic discoveries. Methods: A cross-sectional study was conducted at Darul Sehat Hospital, Zubaida Medical Centre, and Liaquat National Hospital & Medical College, Karachi, Pakistan from 1(st) July 2017 to 30(th) November 2018. Patients scheduled to undergo endoscopy were surveyed before the procedure in which they were asked about demographics, comorbid, and gastrointestinal manifestations. The association between BMI and endoscopic findings and related gastrointestinal symptoms was assessed using Pearson chi square test and binary logistic regression. The significance level was set at 0.05. Results: A total of 2148 subjects were included in the study out of which 20.2% were overweight (BMI 23-24.9) and 20.9% subjects were obese (BMI >25). Both the gastrointestinal symptoms and endoscopic findings were found to be significantly associated with the BMI (p<0.05 for both). Moreover, binary logistic regression revealed obesity to be a significant contributor of abnormal endoscopic findings (adjusted odds ratio, AOR, 2.93; 95% confidence interval, CI, 2.35-3.65). Conclusion: Based on the study results, obesity was identified as a risk factor associated with gastrointestinal symptoms like gastro esophageal reflux disease (GERD) and other related gastrointestinal conditions such as erosive gastritis, duodenal ulcers, reflux esophagitis, and large hiatal hernia.