[Factors related to the presence of reflux in patients with typical symptoms of gastroesophageal reflux disease (GERD)].
OBJECTIVE
To analyze clinical, abdominal ultrasound, upper digestive endoscopic, esophageal manometric and prolonged esophageal pH-monitoring findings in patients with typical symptoms of GERD.


METHODS
The study included a total of 251 patients with typical GERD symptoms. Clinical data, Body Mass Index, abdominal ultrasound aspects and upper digestive endoscopic data are reported. Manometry and esophageal pH-monitoring were performed.


RESULTS
One-hundred-and-seventy-two patients were female (68.5%). Mean age of the total was 51.8 years. Ultrasound examination revealed colelithiasis in 23 patients and PC in 21 patients. Hiatal hernia was diagnosed in 177 patients (71%), with an average size of 3.0 cm. Erosive esophagitis was found in 168 patients (66.9%) and Barrett's esophagus in 23 patients (9.2%). A combination of hiatal hernia and esophagitis was diagnosed in 131 patients (52.3%) while only 37 patients (14.7%) did not present either. The mean extension of the lower esophageal sphincter (LES) was 2.6 cm, whereas in 132 patients (52.6%) the LES was shorter. The mean pressure of the LES was 18.9 mmHg; 46 patients (18.3%) had pressures below 14 mmHg. The mean number of reflux episodes on prolonged esophageal monitoring was 42.9; the mean number of prolonged episodes of reflux was 4.6, and the mean percentage of total acid time was 8.4%. DeMeester scores were high in 175 patients (69.7%).


CONCLUSIONS
In patients with typical GERD symptoms, factors influencing the presence of pathological reflux as confirmed by prolonged esophageal pH-monitoring were: age, hiatal hernia associated to erosive esophagitis, a smaller extension, low baseline pressure and smaller volume vector of the LES.
Corsi
Paulo Roberto
PR
Grupo de Afecções do Esôfago, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, SP. r.corsi@terra.com.br
Gagliardi
Danilo
D
Horn
Mozar
M
Pochini
Celso de Castro
Cde C
Oliveira Neto
Reinaldo Martins de
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004941:Esophagitis / Q000150:complications; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged