Any role for proton pump inhibitors in the relationship between new erosive oesophagitis and abdominal visceral fat?
In a recent interesting work, Nam and colleagues investigated the longitudinal effects of abdominal visceral fat on the development of new erosive oesophagitis in patients who did not have erosive oesophagitis at baseline. The authors found that a higher level of visceral fat at baseline and follow-up visceral fat, and greater changes in the visceral level were associated linearly with the development of new erosive oesophagitis. Among the parameters considered in the statistical analysis, Helicobacter pylori status, hiatal hernia, smoking during follow-up and reflux symptoms were reported 1. No data are reported on the continuous, intermittent or on demand use of proton pump inhibitors (PPIs). As PPIs are a widely used class of drugs, often prescribed to treat reflux symptoms and, on the basis of recent reports, overused 2, they should be considered in the context reported by Nam and colleagues. The exclusion of patients who have used PPIs within the past 4 weeks could avoid false-negative results, but may not help to understand the potential influence of these drugs over time in the development of erosive oesophagitis. These data could enrich the work.