Metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico: prevalência e aspectos clínico-epidemiológicos

Caum, Leiber Carvalho; Bizinelli, Sergio; Pisani, Júlio César; Amarantes, Heda Maria Barska dos Santos; Ioshii, Sérgio Ossamu; Carmes, Eliane Ribeiro

doi:10.1590/s0004-28032003000400005

Cited by 8 publications

(8 citation statements)

References 31 publications

(48 reference statements)

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“…From these, we identified 105 articles that appeared to be relevant to the study question ( Figure 1). There were 44 articles that fulfilled the eligibility criteria, [16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49 Figure 2). The lowest prevalence was 0.6% reported by two studies, both of which were conducted in Turkey, [41,58] and the highest prevalence was 29%, reported in a study from the US.…”

Section: Resultsmentioning

confidence: 99%

Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

Eusebi

Cirota

Zagari

et al. 2020

Gut

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ObjectivesChronic gastro-oesophageal reflux might lead to the development of Barrett’s oesophagus (BO) or even oesophageal adenocarcinoma. There has been no definitive systematic review and meta-analysis of data to estimate global prevalence of BO or oesophageal adenocarcinoma in individuals with gastro-oesophageal reflux.DesignWe searched MEDLINE, Embase and Embase Classic to identify cross-sectional surveys that reported prevalence of BO or oesophageal adenocarcinoma in adults with gastro-oesophageal reflux. We extracted prevalence for all studies, both for endoscopically suspected and histologically confirmed cases. We calculated pooled prevalence according to study location, symptom frequency and sex, as well as ORs with 95% CIs.ResultsOf the 4963 citations evaluated, 44 reported prevalence of endoscopically suspected and/or histologically confirmed BO. Prevalence of BO among individuals with gastro-oesophageal reflux varied according to different geographical regions ranging from 3% to 14% for histologically confirmed BO with a pooled prevalence of 7.2% (95% CI 5.4% to 9.3%), whereas pooled prevalence for endoscopically suspected BO was 12.0% (95% CI 5.5% to 20.3%). There was heterogeneity in many of our analyses. Prevalence of BO was significantly higher in men, both for endoscopically suspected (OR=2.1; 95% CI 1.6 to 2.8) and histologically confirmed BO (OR=2.3; 95% CI 1.7 to 3.2). Dysplasia was present in 13.9% (95% CI 8.9% to 19.8%) of cases of histologically confirmed BO, 80.7% of which was low-grade.ConclusionThe prevalence of Barrett’s oesophagus among individuals with gastro-oesophageal reflux varied strikingly among countries, broadly resembling the geographical distribution of gastro-oesophageal reflux itself. Prevalence of BO was significantly higher in men.

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Section: Resultsmentioning

confidence: 99%

Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

Eusebi

Cirota

Zagari

et al. 2020

Gut

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“…The intestinal metaplasia in Barrett's esophagus due to gastro-esophageal reXux [16] and the histological changes of ortothopic ileal neobladder mucosa [17] are typical examples. From our experience with head and neck reconstruction, we noted that many Xaps transferred to the oral cavity resembled the neighboring mucosa during the follow-up.…”

Section: Discussionmentioning

confidence: 99%

Delayed histological changes in cutaneous portion of pectoralis major flaps employed in upper aero-digestive tract reconstruction

Pinto

Kanda

Diniz

et al. 2008

Eur Arch Otorhinolaryngol

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Our aim was to determine whether histological changes occur in the cutaneous portion of pectoralis major Xaps employed for upper aero-digestive tract reconstruction and, if present, to characterize these changes and try to infer their cause. Seven patients submitted to repair of aerodigestive tract defects secondary to cancer resection with pectoralis major myocutaneous Xap were included in this study. All patients received adjuvant radiotherapy. Biopsies were taken from: the cutaneous portion of the Xap; buccal mucosa; irradiated neck skin and chest skin opposite the donor site. Histological changes toward a "mucosalization" occur in the cutaneous portion of the pectoralis major Xaps, characterized by disappearance of the horny layer or a reduction of its thickness and a decrease of the amount of cutaneous appendages. These changes are probably a result of continuous exposure to the intraoral environment in association with radiotherapy eVects and may represent an advantageous adaptation for the patient.

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“…Embora os sintomas da DRGE e a doença sejam mais freqüen-tes em mulheres, o EB é mais comum em homens 23 . A pHmetria prolongada do esôfago revelou que alguns pacientes considerados portadores de dispepsias inespecíficas, na verdade apresentavam RGE patológico sem lesão da mucosa.…”

Section: Discussionunclassified

Presença de refluxo em pacientes com sintomas típicos de doença do refluxo gastroesofágico

Corsi¹,

Gagliardi²,

Horn³

et al. 2007

Rev. Assoc. Med. Bras.

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INTRODUÇÃOO refluxo gastroesofágico (RGE) é caracterizado pelo retorno espontâneo do conteúdo do estômago para o esôfago. Em todos os seres humanos, pequena quantidade de refluxo ocorre no esôfago distal, fato este que não provoca sintoma ou sinal, sendo chamado de refluxo fisiológico.A doença do refluxo gastroesofágico (DRGE) foi definida pelo Consenso Brasileiro da DRGE como "uma afecção crônica decorrente do fluxo retrógrado de parte do conteúdo gastroduodenal para o esôfago e/ou órgãos adjacentes a ele, acarretando um espectro variável de sintomas e/ou sinais esofagianos e/ou extraesofagianos, associados ou não a lesões teciduais" 1 . A DRGE tem elevada prevalência, acometendo ambos os sexos em todas as faixas etárias. Por esse motivo, tem sido uma das afecções mais comuns nos consultórios de cirurgiões e gastroenterologistas 2-4 . Freqüentemente, os sintomas têm duração prolongada e comprometem a qualidade de vida 5 . Não existem muitos estudos nacionais sobre a epidemiologia da DRGE, entretanto é notória a recente elevação da sua prevalência 1,6,7 . Esta elevada prevalência é devida a vários aspectos, entre eles, a elevação da média de idade da população, maus hábitos alimentares, obesidade ou sobrepeso, fatores genéticos, utilização freqüente da terapia de reposição hormonal e estresse 4,7-9 . O principal elemento na barreira de contenção do RGE é o esfíncter esofágico inferior (EIE), um espessamento da musculatura circular, identificado como uma zona de pressão elevada, de 3 a 4 cm de extensão 10,11 . A falência dos mecanismos de contenção do EIE ocorre quando existe fraqueza da musculatura que causa redução da sua pressão basal, curta extensão, deslocamento do EIE para o tórax ou número excessivo de relaxamentos espontâneos do EIE 12 . A combinação desses eventos é a causa mais freqüente da DRGE [13][14][15] . O material que reflui do estômago para o esôfago é novamente conduzido ao estômago por mecanismo denominado clareamento esofágico. O mecanismo é representado pela peristalse esofágica eficaz, gravidade e deglutição de saliva 15,16 . Vários autores demonstraram que, após um episódio de RGE, o tempo de clareamento esofágico é maior nos pacientes com esofagite do que em indiví-duos normais 15,17,18 . A HH está presente em muitos pacientes com DRGE, principalmente naqueles com esofagite grave 14 , pois causa a ruptura anatômica e funcional dos mecanismos fisiológicos de contenção do RGE, reduzindo a pressão do EIE e dificultando o clareamento esofágico 13,15,17,19,20 . Os sintomas típicos são gastroesofágicos, caracterizados por pirose e sensação de queimação ascendente, muitas vezes até a Rev Assoc Med Bras 2007; 53(2): 152-7

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Metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico: prevalência e aspectos clínico-epidemiológicos

Abstract: Barrett's esophagus was more related to the male gender, gastroesophageal reflux disease symptoms for 5 years or longer, more intense esophagitis and hiatal hernia, but was not related to the use of tobacco and alcohol.

Cited by 8 publications

References 31 publications

Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

Global prevalence of Barrett’s oesophagus and oesophageal cancer in individuals with gastro-oesophageal reflux: a systematic review and meta-analysis

Delayed histological changes in cutaneous portion of pectoralis major flaps employed in upper aero-digestive tract reconstruction

Presença de refluxo em pacientes com sintomas típicos de doença do refluxo gastroesofágico

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