Clinical and Endoscopic Evaluation in Patients With Gastroesophageal Symptoms

Abstract

BACKGROUND: The gastroesophageal reflux disease (GERD) is the most common esophageal disease in medical practice, and it is suspected according to patients’ symptoms. GERD can be classified in erosive esophagitis (EE) according to the presence of upper gastrointestinal endoscopy findings. OBJECTIVE: To evaluate endoscopic findings in patients with symptoms suggestive of GERD comparing epicemiological and risk factors. METHODS: Upper endoscopy reports were examined retrospectively from patients with symptoms of GERD such as heartburn, regurgitation, cough, throat clearing, globus and chest pain. EE was determined based on Los Angeles classification. Comparisons between risk factors in EE and non-EE groups were done with statistical analysis. RESULTS: A total of 984 endoscopic reports were examined and 676 selected for analysis (281 with EE and 395 with non-EE form). Most were female 381 (56.36%) with a mean age of 44.01±15.40 years. Hiatal hernia was present in 47(6.96%) and smoking in 41(6.07%). Univariate logistic regression showed that male (OR=2.24, CI 95%, 1.63-3.06) and hiatal hernia (OR=4.52, CI 95%, 2.30-8.89) were independent predictors of erosions in the EE group. The presence of hiatal hernia (OR=12.04, CI 95%, 3.57-40.62), smoking (OR=8.46, CI 95%, 3.28-31.32) and aged patients (OR=8.01, CI 95%, 2.42-26.49) were also indicated as a risk factor for severe EE (grades C and D of Los Angeles). CONCLUSION Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal hernia were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form.

The effect of anthropometric and metabolic parameters on the development of erosive reflux disease in patients with gastroesophageal reflux disease

“…Male gender was identified as an independent risk factor for ERD. 16 In a study conducted by Nam et al 17 the effects of dietary factors on erosive and non-erosive reflux in 11690 people in Korea in 2017, and it was reported that erosive reflux was more common in male, while non-erosive reflux was more common in female. In a study by Nurleili et al 18 male formed the majority in the group with ERD, while female formed the majority in the group with NERD.…”

Análise das manifestações otorrinolaringológicas da doença do refluxo gastroesofágico em pacientes atendidos em uma unidade de referência em Imperatriz-MA

“…Em termos epidemiológicos, a DRGE é o distúrbio no trato gastrointestinal alto mais comum no mundo ocidental e é a doença esofágica mais prevalente na prática médica 2 . No Brasil, estima-se que 12% da população possui essa afecção 3 , sendo, portanto, uma enfermidade habitual no nosso meio.…”

“…Em suma, dos fatores supracitados, um que merece destaque atualmente é o excesso de peso, existindo evidências claras da sua influência na fisiopatologia da DRGE. Essa condição tem sido associada ao aumento da pressão intra-abdominal, o que, por sua vez, aumenta o gradiente de pressão gastroesofágico, a pressão intragástrica e a chance de se desenvolver hérnia hiatal, componentes diretamente ligados à gênese da patologia pesquisada 2 .…”

Comparação dos achados esofagogastroduodenais da endoscopia de acesso direto com a endoscopia solicitada por especialistas em pacientes da região sul de Mato Grosso

“…Os A conduta inicial para pacientes com dispepsia de início após 40-55 anos de idade e para aqueles com sintomas/sinais de doença orgânica compreende a endoscopia digestiva alta (EDA) 45,46 este diagnóstico foi associado à hérnia hiatal, como anteriormente descrito na literatura 21,112,113 .…”