title: Influence of exercise testing in gastroesophageal reflux in patients with gastroesophageal reflux disease.
abstract: BACKGROUND
  Gastroesophageal 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.
  
  
  OBJECTIVE
  To 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.
  
  
  METHODS
  Twenty-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.
  
  
  RESULTS
  Maximum 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).
  
  
  CONCLUSIONS
  1) 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.
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Antonio Moreira
authors.initials: AM
authors.lastname: Mendes-Filho
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Joaquim Prado Pinto
authors.initials: JP
authors.lastname: Moraes-Filho
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Ary
authors.initials: A
authors.lastname: Nasi
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Jaime Natan
authors.initials: JN
authors.lastname: Eisig
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Tomas Navarro
authors.initials: TN
authors.lastname: Rodrigues
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Ricardo Correa
authors.initials: RC
authors.lastname: Barbutti
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Josemberg Marins
authors.initials: JM
authors.lastname: Campos
authors.affiliation: Department of Gastroenterology, School of Medicine, University of Sao Paulo, Brazil.
authors.forename: Decio
authors.initials: D
authors.lastname: Chinzon
mesh_terms: D000293:Adolescent; D000328:Adult; D005080:Exercise Test; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult