[Obesity, symptoms of gastroesophageal reflux and endoscopic findings in a referral hospital]. / Obesidad, sintomas de reflujo gastroesofágico y hallazgos endoscópicos en un hospital de referencia.

OBJECTIVE: To determine association between obesity, gastroesophageal reflux symptoms, hiatus hernia and erosive esophagitis. METHODS: Consecutive patients who underwent upper endoscopies at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire. Weight and height of all patients were determined. Body mass index was calculated. At endoscopy it was looked for the presence of hiatus hernia and erosive esofagitis. We excluded patients with some of the following conditions: Pregnancy, ascitis, esophageal varices, esophageal, gastric or duodenal stenosis, and patient who required an emergency or therapeutic endoscopy. We compared prevalence of symptomatic GERD, hiatus hernia and erosive esophagitis between normal weight patients, overweight and obese. RESULTS: A total of 196 patients were included for analysis, 122 women and 74 men, mean age 52.5 years, 40.3% were overweight and 28.1% were obese. There were 124 patients (63.3%) with symptoms of GERD determined by the C-D Questionnaire obtained. Hiatus hernia was observed in 87 patients (44.4%), and erosive esophagitis in 69 patients (35.7%). Prevalence of GERD symptoms in obese or overweight patients were similar to those normal-weight patients (66.4% and 56.5% respectively, p = 0.20) OR 1.52 (IC 95%, 0.82-2.82). Among obese or overweight hiatus hernia was observed in 47% compared to 38.7% of those normal-weight (p = 0.28) OR 1.40 (IC 95%, 0.76-2.59). Prevalence of erosive esofagitis was also similar in both groups 37.3% and 32.3% respectively (p = 0.52) OR 1.25 (IC 95%, 0.66-2.36). CONCLUSIONS: This study didn't show association between symptoms of GERD, hiatus hernia or erosive esofagitis and overweight or obesity.

[Association between symptomatic gastroesophageal reflux and Barrett's esophagus]. / Asociación entre reflujo gastroesofágico sintomático y esófago de Barrett.

BACKGROUND DATA: Barrett esophagus is a proximal displacement of the squamocolumnar junction relative to the gastroesophageal junction with intestinal metaplasia, it has been linked to gastroesophageal reflux disease. However, it has been observed in individuals without gastroesophageal reflux symptoms, with prevalence up to 25% in 50 years older men. OBJECTIVE: Assess the association between symptomatic gastroesophageal reflux and Barrett's esophagus. METHODS: Consecutive patients undergoing endoscopy at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire for determining 2 groups (patients with and without gastroesophageal reflux symptoms). Those subjects with suggestive image of Barrett's esophagus, biopsy specimens were obtained from the distal esophageal mucosa with the intention of find intestinal metaplasia. We compared prevalence of Barrett's esophagus between groups. RESULTS: One hundred and nine patients were studied. Prevalence of symptomatic gastroesophageal reflux disease was 37.6%. Barrett's esophagus was found in 9.7% of symptomatic gastroesophageal reflux disease patients and in 9.6% of subjects without symptoms of gastroesophageal reflux disease (p = 0.87). Gender and age were similar between groups. Prevalence of hernia hiatal was bigger in patients with Barrett's esophagus (90 vs. 42%) (p = 0.004). CONCLUSION: Our study didn't show association between symptomatic gastroesophageal reflux detected by a questionnaire and Barrett's esophagus.

Prevalencia de hernia hiatal y esofagitis crónica en pacientes asmáticos adultos / Prevalence of hiatus hernia and chronic esophagitis in adult asthmatic patients

Antecedentes: la concomitancia entre asma, hernia hiatal, esofagitis y reflujo gastroesofágico se ha reportado como factor causal que altera la evolución clínica del asma. Material y método: estudio prospectivo, longitudinal y comparativo efectuado con un grupo de 90 pacientes con asma leve y moderada persistente, de origen alérgico, con una edad promedio de 35.9 años. Al cabo de seis meses de tratamiento inmunoalérgico se valoró la respuesta clínica que se clasificó en dos grupos: el grupo A lo integraron 40 pacientes con asma leve intermitente y el B 50 individuos con asma moderada severa persistente. A los dos grupos se les realizó esofagogastroscopía para poder establecer el diagnóstico de la afección esofágica, con biopsia en los tres tercios esofágicos. Se registraron los síntomas de reflujo gastroesofágico. Resultados: se encontró hernia hiatal en 33 pacientes, 12 del grupo A y 21 del B. Esofagitis proximal en 21 pacientes, 8 del grupo A y 13 del B. Síntomas de reflujo gastroesofágico en 71 pacientes, 29 del grupo A y 42 del B. La asociación de hernia hiatal-esofagitis-reflujo gastroesofágico se observó en 12 pacientes, dos del grupo A y 10 del B (p< 0.05). Conclusiones: la asociación de síntomas de reflujo gastroesofágico, hernia hiatal y esofagitis proximal es mayor en los pacientes con mala respuesta al tratamiento antiasmático. En el grupo de pacientes con mala respuesta y síntomas de reflujo gastroesofágico se justifica la realización de la endoscopía y la toma de biopsias del esófago proximal cuando no se cuenta con pH-metría de 24 horas.