ABSTRACT
A doença do refluxo gastroesofágico é decorrente do fluxo retrógrado de secreção cloridropéptica para o esôfago e órgãos adjacentes, causando um espectro variável de lesões e sintomas. Sua incidência vem aumentando nos últimos anos e sua prevalência estimada na população brasileira é de cerca de 12%. A DRGE tem como manifestações típicas a pirose e a regurgitação, podendo se apresentar com queixas extraesofágicas tais como asma, tosse crônica, dor torácica não cardíaca e sintomas otorrinolaringológicos.
Gastro-oesophageal reflux disease is caused by the retrograde flow of gastric acid-peptic secretion into the esophagus and adjacent organs, causing a variable spectrum of lesions and symptoms. Its incidence has been increasing in recent years and its estimated prevalence in the Brazilian population is about 12%. Typical manifestations of GERD are heartburn and regurgitation, but the disease may present with extraesophageal complaints such as asthma, chronic cough, non-cardiac chest pain and ENT symptoms.
Subject(s)
Humans , Male , Female , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/epidemiology , Gastroesophageal Reflux/therapy , Laryngopharyngeal Reflux/diagnosis , Laryngopharyngeal Reflux/therapy , Asthma/etiology , Chest Pain/etiology , Esophageal pH Monitoring , Esophagoscopy/methods , Proton Pump Inhibitors/therapeutic use , Otorhinolaryngologic Diseases/etiology , Pepsin A/analysis , Saliva/chemistry , Cough/etiologyABSTRACT
RACIONAL: As dores de origem esofagiana e coronariana são bastante semelhantes do ponto de vista clínico, havendo necessidade de exclusão desta última, que ocasiona risco de morte. A investigação esofagiana tradicional de pacientes com dor torácica de origem indeterminada, envolve emprego de endoscopia digestiva alta, esofagomanometria e pHmetria esofagiana prolongada. Esses métodos, embora de grande importância diagnóstica, muitas vezes, revelam alterações, em sua maioria, potenciais para a origem da dor. Os testes provocativos de dor esofagiana, ao reproduzirem-na em laboratório, apontam com segurança a sua origem.OBJETIVOS: Determinar a positividade dos testes de perfusão ácida, do edrofônio e da distensão esofagiana com balão em pacientes com dor torácica de origem indeterminada, e correlacionar os resultados com os testes habitualmente empregados, estabelecendo o ganho no diagnóstico da dor esofagiana comprovada...
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Chest Pain/diagnosis , Esophageal Diseases/diagnosis , Cross-Sectional Studies , Chest Pain/etiology , Diagnosis, Differential , Esophagoscopy , Edrophonium , Esophageal Diseases/complications , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/diagnosis , Hydrogen-Ion Concentration , Manometry , Prospective StudiesABSTRACT
BACKGROUND: In GERD patients, ineffective esophageal motility (IEM), a hypocontractile disorder, is the most common motor abnormality. IEM has been associated with reflux in both the supine and upright position, prolonged esophageal clearance, and delayed of bolus transport. IEM has been equally present in erosive and in nonerosive GERD. GOAL: Considering that reflux has been found to be more severe in erosive GERD than in nonerosive GERD patients and that IEM delays esophageal clearance, our hypothesis is that patients with erosive GERD have more severe IEM than those with nonerosive disease. STUDY: A retrospective review of consecutive manometries of patients with the chief complaint of heartburn and a diagnosis of IEM were performed, and patients with both erosive and nonerosive GERD were selected. According to the number of ineffective contractions, IEM was stratified into three groups: 30% to 40%, mild; 50% to 60%, moderate; and greater than 60%, severe. We also registered the number of low amplitude, failed, and normal waves in each manometry of both groups. We evaluated 110 patients: 70 (64%) with erosive GERD and 40 (36%) with nonerosive GERD. The percentage of mild, moderate and severe IEM was similar in erosive and in nonerosive GERD patients, as well the number of low amplitude, failed or normal waves (P < 0.5). CONCLUSION: There were no differences between the severity of IEM in erosive and in nonerosive GERD patients.
