Nonalcoholic fatty liver disease increases risk for gastroesophageal reflux symptoms

Dig Dis Sci. 2014 Aug;59(8):1939-45. doi: 10.1007/s10620-014-3113-7. Epub 2014 Apr 10.


Background: Nonalcoholic fatty liver disease (NAFLD) is now recognized as a leading cause of liver dysfunction. Gastroesophageal reflux disease (GERD) is a common disorder causing symptoms that often impair patients' quality of life. In recent years, the prevalence of both these diseases has increased, partially overlapping the rise of metabolic disorders.

Aims: We investigated whether a relation does exist between NAFLD and GERD symptoms.

Methods: Cross-sectional study among 206 outpatients diagnosed with NAFLD and 183 controls. We collected clinical and laboratory data, assessed severity and frequency of GERD symptoms and the esophageal endoscopic pattern.

Results: The prevalence of GERD symptoms was higher in NAFLD patients than controls (61.2 vs. 27.9%, p < 0.001). We found a positive association between NAFLD and the experiencing of heartburn, regurgitation and belching. GERD symptoms were related to body mass index (BMI) and metabolic syndrome (MetS); a strong association persisted after adjustment for all the covariates (adjusted OR 3.49, 95 CI% 2.24-5.44, p < 0.001).

Conclusions: Our data show that the prevalence of GERD typical symptoms is higher in patients with NAFLD. GERD was associated with higher BMI and MetS, but not with age and diabetes type 2. NAFLD remained strongly associated with GERD, independently of a coexisting MetS status. Consistent with these findings, MetS can be considered a shared background, but cannot completely explain this correlation. We suggest NAFLD as an independent risk factor for GERD symptoms.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Comorbidity
  • Cross-Sectional Studies
  • Fatty Liver / complications*
  • Fatty Liver / epidemiology*
  • Female
  • Gastroesophageal Reflux / epidemiology*
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors