Pavel Svoboda, Petr Dítě, Pavel Klvaňa, Martina Bojková, Tomáš Kupka, Martin Rydlo
The common increase of obesity and oesophageal reflux disease gave rise to the idea of common pathogenetic factors
of both diseases, and initiated a great interest in clarification of the relationship. Various studies and meta-analyses
proved a relation between the metabolic syndrome, or central obesity and oesophageal reflux disease, Barrett’s
oesophagus and oesophageal adenocarcinoma. Factors contributing to the oesophageal reflux disease and its complications
in patients with central obesity include: increased intra-abdominal pressure, which is further responsible for increase
of intragastric pressure, and thus supports reflux and increases the risk of diaphragmatic hernia, furthermore
also impaired gastric emptying, decreased tonus of lower oesophageal sphincter, and oesophageal motility impairment.
The visceral fat is metabolically active, and is associated with a low level of protective cytokines, such as adiponectin,
and with high levels of pro-inflammatory cytokines, such as TNF-α, IL-1β and IL-6. These cytokines potentiate
inflammation and may potentiate also malignant transformations in patients with Barrett’s oesophagus.