ACLARAMIENTO ESOFAGICO PDF

Impaired esophageal motor function in eosinophilic esophagitis. Cecilio Santander, Carlos M. Servicio de Aparato Digestivo, Unidad de Motilidad. Hospital Universitario de La Princesa. Eosinophilic esophagitis is a chronic immunoallergic inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment.

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Universidad Nacional de Colombia. El cambio en el estilo de vida es recomendado, sin embargo la evidencia que la soporta es controvertida y escasa. Objetivo : estimar el impacto que tienen los cambios en el estilo de vida en los pacientes con ERGE.

Background : Gastroesophageal reflux disease GERD is a very prevalent disease among adults that alters the quality of life. Many treatments have been investigated, some of which require changes in lifestyle related to associated risk factors.

Although changes in lifestyle are recommended, the evidence that supports these recommendations is controversial and scarce. Objective : The objective of this study is to estimate the impact of lifestyle changes on patients with GERD.

Methodology : A systematic search of the literature in PubMed, Science Direct and Embase was conducted using the following keywords: gastroesophagueal sic reflux, heartburn, bed head elevation, Carbonated Beverages, mint, cocoa, citrus, Drinking Alcohol, caffeine, coffee, late-evening meal, spicy food, fatty foods, obesity, weight loss, exercise and Smoking Cessation.

Controlled clinical trials and prospective cohort studies that studied lifestyle changes and their effects on GERD were included in the study. Results : Of the 2, articles found, fifteen were included in our analysis. There is little evidence that suspending consumption of food or drink items such as peppermint, chocolate, citrus, carbonated beverages, fatty foods and spicy foods clinically improves GERD.

Decaffeinated coffee may decrease the amount of reflux, and quitting smoking is associated with improvement in symptoms. Meal times at night can change some parameters of pH monitoring but did not alter symptoms.

Some exercises, mainly respiratory, may improve symptoms. There is evidence that elevating the head while in the bed and weight loss in cases of overweight or obese patients improve symptoms, but there is also evidence against these methods and studies of them have methodological limitations.

Most studies are uncontrolled clinical trials or observational studies. Additional clinical trials with better quality are needed to define the impact of these measures on GERD.

No obstante el impacto negativo en la calidad de vida, la ERGE no disminuye la sobrevida La utilidad de estas medidas es controvertida. Se utilizaron las palabras claves: "gastroesophagueal reflux", "heartburn", "bed head elevation", "Carbonated Beverages", "mint", "cacao", "citrus", "alcohol drinking", "caffeine", "coffee", "late-evening meal", "spicy food", "fatty foods", "obesity", "weight loss", "exercise" y "smoking cessation".

Los resultados de cada estudio fueron ingresados al programa RevMan 5 de la Biblioteca de Cochrane. El nivel de evidencia puede variar entre Alta es muy poco probable que nuevos estudios modifiquen la confianza que se tiene en el resultado estimado ; Moderada es probable que nuevos estudios tengan un impacto importante en la confianza que tenemos en el resultado estimado y que estos puedan modificar el resultado ; Baja es muy probable que nuevos estudios tengan un impacto importante en la confianza que se tiene en el resultado estimado y que estos puedan modificar el resultado.

Muy baja cualquier resultado estimado es muy incierto. Las bebidas carbonatadas se han considerado precipitantes de la ERGE, aunque existe controversia. Sin embargo, otros estudios observacionales no han encontrado al consumo de alcohol como factor de riesgo para ERGE Sin embargo, algunos estudios han reportado resultados diferentes.

Dos estudios experimentales han tratado de evaluar el efecto de comer a diferentes horas sobre la ERGE. Pasaron a dormir a las y fueron despertados a las Hay que tener en cuenta que en este estudio la comida previa a las no fue estandarizada y les fue permitido ir al laboratorio en 2 noches separadas hasta por 3 semanas lo que permite mayor variabilidad El promedio de tiempo previo a ir a dormir en los que estaban asignados a cenar tarde fue de 93 minutos, mientras que en los que estaban asignados a cenar temprano fue de minutos.

El estudio fue doble ciego durante las primeras 13 semanas. A los pacientes les fue permitido utilizar inhibidores de bomba de protones a demanda. El horario de comida se ha investigado y se han encontrado resultados contradictorios. Tampoco encontramos evidencia concluyente con otras medidas como elevar la cabecera de la cama. William Otero declara que ha recibido honorarios por conferencias de los siguientes laboratorios: Abbott-Lafrancol, Sanofi, Tecnofarma, Takeda, Janssen, Procaps y Biotoscana.

The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. Haruma K. Systematic review of the epidemiology of gastroesophageal reflux disease in Japan.

J Gastroenterol. Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Salis G. Gastro-oesophageal reflux symptoms and health-related quality of life in the adult general population--the Kalixanda study. Pharmacol Ther. Becher A, El-Serag H. Systematic review: the association between symptomatic response to proton pump inhibitors and health-related quality of life in patients with gastro-oesophageal reflux disease.

Vakil NB, Traxler B. Levine D. Dysphagia in patients with erosive esophagitis: prevalence, severity, and response to proton pump inhibitor treatment. Clin Gastroenterol Hepatol. Inadomi JM. Esophageal adenocarcinoma incidence in individuals with gastroesophageal reflux: synthesis and estimates from population studies. The association between gastro-oesophageal reflux disease and asthma: a systematic review. Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans.

Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis. The natural history of gastro-oesophageal reflux symptoms in the community and its effects on survival: a longitudinal year follow-up study. Aliment Pharmacol Ther. Transient lower esophageal sphincter relaxation. Gastro-oesophageal reflux disease.

Boeckxstaens GE. The position of the acid pocket as a major risk factor for acidic reflux in healthy subjects and patients with GORD.

Arch Intern Med. Accesado Septiembre 5, Systems for grading the quality of evidence and the strength of recommendations II: pilot study of a new system. Fat and esophageal sensitivity to acid. Dig Dis Sci. A comparison of high and low fat meals on postprandial esophageal acid exposure. Effect of low and high fat meals on lower esophageal sphincter motility and gastroesophageal reflux in healthy subjects.

Effect of increasing the fat content but not the energy load of a meal on gastro-oesophageal reflux and lower oesophageal sphincter motor function. Duodenal fat intensifies the perception of heartburn. Effect of intraduodenal fat on lower oesophageal sphincter function and gastro-oesophageal reflux. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms.

Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. Prevalence of heartburn and gastroesophageal reflux disease in the urban Brazilian population. Arq Gastroenterol. Perception of gastroesophageal reflux disease in urban population in Pakistan.

J Coll Physicians Surg Pak. Butt AK, Hashemy I. J Pak Med Assoc. Relationship between gastroesophageal reflux symptoms and dietary factors in Korea.

J Neurogastroenterol Motil. Prevalence and determinants of frequent gastroesophageal reflux symptoms in the Australian community. Dis Esophagus. Response of the lower esophageal sphincter to gastric distention by carbonated beverages. J Gastrointest Surg. Ingestion of a carbonated beverage decreases lower esophageal sphincter pressure and increases frequency of transient lower esophageal sphincter rela xation in normal subjects.

Indian J Gastroenterol. Predictors of heartburn during sleep in a large prospective cohort study. Gastro-esophageal reflux disease in Lebanese adults: Effects on quality of life and correlates. J Popul Ther Clin Pharmacol. Sweetened carbonated drinks do not alter upper digestive tract physiology in healthy subjects.

Neurogastroenterol Motil. Lack of effect of spearmint on lower oesophageal sphincter function and acid reflux in healthy volunteers. The adverse effect of chocolate on lower esophageal sphincter pressure.

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Universidad Nacional de Colombia. El cambio en el estilo de vida es recomendado, sin embargo la evidencia que la soporta es controvertida y escasa. Objetivo : estimar el impacto que tienen los cambios en el estilo de vida en los pacientes con ERGE. Background : Gastroesophageal reflux disease GERD is a very prevalent disease among adults that alters the quality of life. Many treatments have been investigated, some of which require changes in lifestyle related to associated risk factors. Although changes in lifestyle are recommended, the evidence that supports these recommendations is controversial and scarce.

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Cough occurs due to the complex action of the coughing arch. Under normal conditions it is essential to protect the airway. It is a very frequent symptom with a large of possible etiologies. The diagnosis process of patients with chronic cough can be a challenge. The most prevalent pathologies must be considered. Thus includes pharyngolaryngeal reflux and posterior discharge: both conditions that are part of the otorhinolaryngolocical area. In the present article review, we pretend to provide an updated approach and management to this condition, in order to asses relevant information to daily clinical practice.

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