Influence of exercise testing in gastroesophageal reflux in patients with gastroesophageal reflux disease

Abstract

BackgroundGastroesophageal reflux disease is a worldwide prevalent condition that exhibits a large variety of signs and symptoms of esophageal or extra-esophageal nature and can be related to the esophagic adenocarcinoma. In the last few years, greater importance has been given to the influence of physical exercises on it. Some recent investigations, though showing conflicting results, point to an exacerbation of gastroesophageal reflux during physical exercises.AimTo evaluate the influence of physical activities in patients presenting with erosive and non erosive disease by ergometric stress testing and influence of the lower esophageal sphincter tonus and body mass index during this situation.MethodsTwenty-nine patients with erosive disease (group I) and 10 patients with non-erosive disease (group II) were prospectively evaluated. All the patients were submitted to clinical evaluation, followed by upper digestive endoscopy, manometry and 24 h esophageal pH monitoring. An ergometric testing was performed 1 h before removing the esophageal pH probe. During the ergometric stress testing, the following variables were analyzed: test efficacy, maximum oxygen uptake, acid reflux duration, gastroesophageal reflux symptoms, influence of the lower esophageal sphincter tonus and influence of body mass index in the occurrence of gastroesophageal reflux during these physical stress.ResultsMaximum oxigen consumption or VO 2 max, showed significant correlation when it was 70% or higher only in the erosive disease group, evaluating the patients with or without acid reflux during the ergometric testing (p=0,032). The other considered variables didn't show significant correlations between gastroesophageal reflux and physical activity (p>0,05).Conclusions1) Highly intensive physical activity can predispose the occurrence of gastroesophageal reflux episodes in gastroesophageal reflux disease patients with erosive disease; 2) light or short sessions of physical activity have no influence on reflux, regardless of body mass index; 3) the lower esophageal sphincter tonus does not influence the occurrence of reflux disease episodes during exercise testing.

Different Effects of Aerobic Exercise and Diaphragmatic Breathing on Lower Esophageal Sphincter Pressure and Quality of Life in Patients with Reflux: A Comparative Study

“…Menedes and colleagues concluded that light or short sessions of physical activity had no influence on reflux symptoms, but in the present study, the QOL of the patients was significantly improved. 17 In the present study, AE had positive effects on QOL without any significant change in LES pressure. Maybe change in mental aspects by AE improve the QOL of the patients.…”

“… 15 Other studies conclude that moderate AE has no influence on reflux. 16 , 17 So, the aim of this study was to compare the effects of AE and DB on LES pressure and QOL of patients with reflux.…”

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents

“…In this study, only self-reported symptomatic gastric reflux was investigated and non-symptomatic reflux was, therefore, not taken into consideration. The influence from physical activity on gastroesophageal reflux has been discussed with contradictory opinions [46,47], but this was not investigated in this study. Several authors have reported that parental attitude and habits towards SDC and availability of soft drinks in school and at home affect consumption [3][4][5][14][15][16].…”

Physical activity and the risk of Barrett's esophagus

“…Mendes-Filho et al in Brazil performed a study involving 29 patients with GERD where they reported that patients had significant amount of acid reflux measured via continuous esophageal pH probes when they reached their VO2max of exercise tolerance (high-intensity exercise) on ergonomic stress testing. 16 Other studies refuted this observation, 17,18 whereas Djarv et al found that intermediate frequency of physical activity might decrease the risk of GERD in obese individuals (OR 0.41, 95% CI 0.22-0.27). 17 Given our findings in this study suggesting that physical activity does not reduce the risk of BE, and the mixed findings of studies of physical activity and the development of esophageal adenocarcinoma, it remains to be determined if physical activity affects the risk of progression from BE to esophageal adenocarcinoma.…”

“…Mendes‐Filho et al . in Brazil performed a study involving 29 patients with GERD where they reported that patients had significant amount of acid reflux measured via continuous esophageal pH probes when they reached their VO 2max of exercise tolerance (high‐intensity exercise) on ergonomic stress testing . Other studies refuted this observation, whereas Djarv et al .…”