RESUMO
OBJECTIVE: To evaluate the association between ineffective oesophageal motility and reflux oesophagitis controlling for hiatal hernia, hypotensive lower oesophageal sphincter and male sex in patients with gastro-oesophageal reflux disease. METHODS: A total of 387 patients with reflux disease (mean age, 46 years, 42% men) were consecutively selected from a database. All patients underwent upper endoscopy, oesophageal manometry and 24 h oesophageal pH-metry in accordance with a standardized protocol. Reflux disease was confirmed either by endoscopy (oesophagitis grade I-IV according to Savary-Miller) or by pH-metry (increased acid exposure). Hiatal hernia was diagnosed endoscopically, whereas ineffective oesophageal motility and hypotensive lower oesophageal sphincter were characterized during manometry testing. The association between ineffective oesophageal motility and reflux oesophagitis was assessed by logistic regression analysis. RESULTS: A total of 166 patients with oesophagitis (mean age 45 years, 49% men) and 221 without oesophagitis (mean age 46 years, 37% men) were present. Prevalences of ineffective oesophageal motility, hiatal hernia, hypotensive lower oesophageal sphincter and male sex were significantly higher in patients with oesophagitis compared with those without oesophagitis (P<0.05). Ineffective oesophageal motility was independently associated with oesophagitis after multivariate logistic regression analysis (odds ratio=1.68; 95% confidence interval=1.04-2.70). CONCLUSION: Ineffective oesophageal motility is associated with reflux oesophagitis, independently of hiatal hernia, hypotensive lower oesophageal sphincter and male sex.
Assuntos
Transtornos da Motilidade Esofágica/complicações , Esofagite Péptica/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos da Motilidade Esofágica/diagnóstico , Monitoramento do pH Esofágico , Esofagoscopia , Feminino , Refluxo Gastroesofágico/complicações , Hérnia Hiatal/complicações , Humanos , Masculino , Manometria/métodos , Pessoa de Meia-Idade , Monitorização Ambulatorial/métodos , Fatores SexuaisRESUMO
Os autores relatam um caso de Síndrome de Peutz-Jeghers em paciente de vinte e oito anos de idade que apresenta os principais aspectos clínicos da doença, ou seja, pigmentaçäo melânica mucocutânea e pólipos no trato digestivo e, devido a um episódio de intussuscepçäo intestinal, foi submetida a tratamento cirúrgico com boa evoluçäo clínica
