Gastroesophageal Reflux Disease

Kahrilas, Peter J.

doi:10.1001/jama.1996.03540120061035

Cited by 258 publications

(94 citation statements)

References 96 publications

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“…Contudo, as poucas revisões sistemáticas publicadas apresentam resultados confl itantes (7,14,18,33,41) . Estudo baseado em revisão sistemática de literatura (15) , avaliando a efi cácia do tratamento cirúrgico do refl uxo no controle da asma, conclui que: "o tratamento cirúrgico do refl uxo melhora os sintomas do refl uxo e da asma e reduzem a necessidade de medicamentos, mas tem pouco ou nenhum efeito sobre a função pulmonar".…”

Section: Intolerância Ao Controle Clínico Prolongadounclassified

Doença do refluxo gastroesofágico: revisão ampliada

Nasi

Moraes-Filho

Cecconello

2006

Arq. Gastroenterol.

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A doença do refl uxo gastroesofágico (DRGE), considerada uma das afecções digestivas de maior prevalência nos paises ocidentais (22) , tem sido bastante estudada. Merece destaque o grande número de publicações existentes na literatura médica sobre a mesma. Contudo, há controvérsia em relação a vários aspectos relevantes da afecção.O objetivo do presente estudo foi salientar tópicos importantes da doença e apresentar revisão de literatura do tema. Foram revistos os seguintes tópicos: defi nição, prevalência, manifestações clínicas, diagnóstico, indicações e limitações dos principais métodos diagnósticos e tratamento clínico, cirúrgico e endoscópico. Estratégia de pesquisa e critérios de seleção de trabalhosPesquisou-se, via Internet, artigos de revisão, consensos, "guidelines" e revisões sistemáticas de literatura com meta-análise, publicados nos últimos 5 anos (2000 a 2005), nas seguintes bases de dados: Central de Registro de Estudos Controlados da Cochrane Library e na PubMed. Dentre muitos trabalhos encontrados, foram selecionados nove revisões sistemáticas de literatura com meta-análise, cinco revisões de literatura com critérios de inclusão bem defi nidos, cinco "guidelines" e quatro publicações de consensos, que abordassem os tópicos propostos para a revisão. foram selecionados nove revisões sistemáticas de literatura com meta-análise, cinco revisões de literatura com critérios de inclusão bem defi nidos, cinco "guidelines" e quatro publicações de consensos, que abordassem os tópicos propostos para a revisão. Vale salientar que, como se observa nas referências bibliográfi cas, não foram consideradas apenas as publicações encontradas na referida pesquisa; outras publicações relevantes (algumas anteriores ao período de tempo analisado) foram consideradas na redação do presente texto. Conclusões -Dentre as 12 conclusões apresentadas, destacam-se duas: 1. a impedanciometria esofágica tem contribuído substancialmente para o melhor conhecimento da doença do refl uxo gastroesofágico e se desponta, quando associada à pHmetria (impedanciopHmetria esofágica), como o novo padrão-ouro para o diagnóstico do refl uxo gastroesofágico, e 2. dentre os sintomas da afecção há os que podem ser considerados ácido-dependentes que costumam responder bem ao tratamento com inibidores de bomba de prótons. Contudo, há também sintomas que são mais dependentes da presença física do refl uxo do que da sua acidez. Esses, que não dependem tanto do teor ácido do refl uxo, não são bem controlados pelo uso de anti-secretores. DESCRITORES -Refl uxo gastroesofágico. Esofagite. Transtornos da motilidade esofágica.

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Section: Intolerância Ao Controle Clínico Prolongadounclassified

Doença do refluxo gastroesofágico: revisão ampliada

Nasi

Moraes-Filho

Cecconello

2006

Arq. Gastroenterol.

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“…Eine Reihe von epidemiologischen Untersuchungen zeigt, daû in der westlichen Welt etwa 10±20 % der Bevölkerung häufig unter typischen Refluxbeschwerden wie Sodbrennen und Säureregurgitation leiden [12,13,16,18,24]. Darüber hinaus ist ein vermehrter Reflux von Mageninhalt bei bis zu 50 % der Patienten mit nichtkardialem Brustschmerz, chronischer Heiserkeit, oder rezidivierenden Aspirationspneumonien für die Beschwerden verantwortlich [12,18,24].…”

Section: Epidemiologie Und Natürlicher Verlauf Der Refluxkrankheitunclassified

“…Darüber hinaus ist ein vermehrter Reflux von Mageninhalt bei bis zu 50 % der Patienten mit nichtkardialem Brustschmerz, chronischer Heiserkeit, oder rezidivierenden Aspirationspneumonien für die Beschwerden verantwortlich [12,18,24]. Das Spektrum des Schweregrades der Refluxkrankheit reicht hierbei von gelegentlich milden Symptomen ohne Oesophagitis, über die erosive Oesophagitis bis hin zu peptischen Stenosen und dem Barrett-Oesophagus mit seinem bekannten malignen Potential [12,18]. Bei der überwie-genden Mehrzahl der betroffenen Patienten ist das Ausmaû der Erkrankung gering und führt nicht zum Arztbesuch.…”

Section: Epidemiologie Und Natürlicher Verlauf Der Refluxkrankheitunclassified

“…Bei der überwie-genden Mehrzahl der betroffenen Patienten ist das Ausmaû der Erkrankung gering und führt nicht zum Arztbesuch. Patienten, bei denen aufgrund von Refluxbeschwerden eine Endoskopie durchgeführt wird, zeigen jedoch in bis zu 40 % eine erosive Oesophagitis oder einen Barrett-Oesophagus [12,18].…”

Section: Epidemiologie Und Natürlicher Verlauf Der Refluxkrankheitunclassified

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Indikation zur Antirefluxchirurgie des Oesophagus

Stein

Feußner

Siewert

1998

Chirurg

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In the Western world gastroesophageal reflux disease constitutes the single most common benign disorder of the upper gastrointestinal tract. Current medical therapy with proton pump inhibitors allows physicians to provide complete symptom relief and healing of acute esophageal mucosal injury in practically all affected patients. However, up to 50% of patients require maintenance therapy to prevent relapse. In these patients laparoscopic antireflux surgery offers an attractive and cost-effective alternative to potentially life-long medical therapy. Consequently, every patient with persistent or recurrent symptoms and/or complications of gastroesophageal reflux who depends on maintenance medical therapy to remain in remission is a potential candidate for laparoscopic antireflux surgery, particularly if of young age, suffering from side effects of medical therapy or worrying about long-term safety of the conservative treatment alternatives. A careful selection of patients, objective documentation of gastroesophageal reflux disease by 24-h esophageal pH monitoring, and meticulous attention to the technical details of the procedure are essential for a successful outcome of antireflux surgery.

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Dietary fibre intake and its role in the oesophageal inflammation–metaplasia–adenocarcinoma sequence

et al. 2009

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Recurrent gastric acid reflux can result in inflammation and mucosal erosions in the squamous epithelium of the oesophagus, a condition known as reflux oesophagitis (RO) (1) . Over time, Barrett's oesophagus (BO) can develop when these cells in the distal oesophagus undergo a permanent metaplastic change to columnar-type epithelium (2) . BO is a premalignant condition for oesophageal adenocarcinoma (OAC) and incidence rates of this cancer have tripled in the UK over recent decades (2,3) . Foods containing dietary fibre may protect against oesophageal cancer (4) ; however, the association with OAC specifically, and the stage at which fibre may exert its effect in the inflammation-metaplasiaadenocarcinoma sequence, remains to be clarified.In an all-Ireland case-control study information was collected from patients with OAC (n 224), long-segment BO (n 220), RO (n 219) and healthy population-based controls (n 256) on lifestyle factors and dietary intake using a 101-item FFQ between March 2002 and July 2005. Multiple logistic regression analysis was applied to examine the association between dietary Englyst fibre intake and disease risk, comparing the highest with the lowest tertiles of intake and also using continuous variables. Regression models adjusted for confounding variables including age, gender, energy intake, smoking, education, occupation, alcohol, medication use and after further adjustment for Helicobacter pylori infection.No significant association was identified between fibre intake and RO risk. Dietary fibre was strongly inversely related to BO risk when examining both the highest v. lowest tertile of intake (OR 0.44 (95 % CI 0.25, 0.80)) and per 10 g/d increment in intake (OR 0.54 (95% CI 0.36, 0.83)). This protective association was slightly strengthened after further adjustment for H. pylori infection. An inverse association was also observed between fibre intake and OAC risk, although a dose-response relationship was not apparent, as the reduced risk peaked in the middle tertile of intake (OR 0.52 (95 % CI 0.29, 0.98)).Fibre does not appear to have a role in the initiation stages of OAC development, as intake was unrelated to RO risk. The present study is the first to demonstrate a strong inverse association between fibre intake and BO risk, suggesting a protective effect of dietary fibre in the intermediate stage of the oesophageal inflammation-metaplasia-adenocarcinoma sequence. Fibre intake was also inversely associated with OAC risk, although the effect appeared to plateau in the middle tertile of intake.

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Gastroesophageal Reflux Disease

Cited by 258 publications

References 96 publications

Doença do refluxo gastroesofágico: revisão ampliada

Doença do refluxo gastroesofágico: revisão ampliada

Indikation zur Antirefluxchirurgie des Oesophagus

Dietary fibre intake and its role in the oesophageal inflammation–metaplasia–adenocarcinoma sequence

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