Esophageal manometry findings and degree of acid exposure in short and long Barrett's esophagus64-68



Document title: Esophageal manometry findings and degree of acid exposure in short and long Barrett's esophagus64-68
Journal: Arquivos de gastroenterologia=Archives of gastroenterology
Database: PERIÓDICA
System number: 000425411
ISSN: 0004-2803
Authors: 1
1
1
1
1
Institutions: 1Universidade Federal do Rio de Janeiro, Servico de Gastroenterologia, Rio de Janeiro. Brasil
Year:
Season: Ene-Mar
Volumen: 49
Number: 1
Pages: 64-68
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico
English abstract ABSTRACT – Context - Barrett’s esophagus (BE) is characterized by intestinal metaplasia in the distal esophagus and is classified as short-segment (<3 cm – SSBE) or long-segment (>3 cm - LSSBE). It is suggested that LSSBE is associated with more severe esophageal motor abnormalities and increased acid exposure time than SSBE. Objective - To evaluate the prevalence of esophageal manometriy abnormalities and acid exposure times in patients with SSBE and LSSBE. Methods - Barrett’s esophagus patients identified by upper endoscopy and confirmed by histopathology were, retrospectively, reviewed and divided into two groups: SSBE and LSBE. Demographic data, symptom duration, prevalence of hiatal hernia, lower esophagus sphincter basal pressure, prevalence of esophageal body abnormalities and acid exposure times were evaluated. Results - Forty-six patients with SSBE (24 males - 52.2%, mean age of 55.2 years) and 28 patients with LSBE (18 males - 64.3%, mean age of 50.5 years). Mean symptom duration was 9.9 years for SSBE and 12.9 years for LSSBE. Hiatal hernia was present in 84.2% of SSBE, 96.3% of LSBE; average lower esophagus sphincter pressure in SSBE 9.15 mm Hg, in LSBE 6.99 mm Hg; lower esophagus sphincter hypotension in SSBE was 65.9%, in LSSBE 82.1%; aperistalsis in SSBE 6.5%, LSSBE 3.6%; mild/moderate ineffective esophageal motility in SSBE 34.8%, LSBE 46.4%; severe moderate ineffective esophageal motility in SSBE 10.9%, LSBE 7,1%; nutcracker esophagus/segmental nutcracker esophagus in SSBE 8.6%, LSBE 0%; normal body in SSBE 39.1%, in LSBE 42.9%, no statistical difference for any of these values (P<0.05). Average % total time pH<4 in SSBE 9.12, LSBE 17.27 (P<0.000); % time pH<4 upright in SSBE 11.91; LSBE 24.29 (P=0.003); % time pH<4 supine in SSBE 10.86, LSBE 33.26 (P = 0.000). Conclusion - There was no difference between the prevalence of motor disorders in patients with SSBE and LSSBE. Acid reflux in upright and supine positions was more intense in
Portuguese abstract RESUMO – Contexto - O esôfago de Barrett (EB) se caracteriza pela presença de metaplasia intestinal no esôfago distal, quando menor que 3 cm é chamado Barrett curto (EBC) e com 3 cm ou mais Barrett longo (EBL). Sugere-se que o EBL cursa com mais alterações motoras esofagianas e com refluxo mais intenso que o EBC. Objetivo - Avaliar a prevalência de alterações manométricas e a intensidade do refluxo gastroesofágico à pHmetria em pacientes com EBC e EBL. Métodos - Estudo retrospectivo de pacientes com endoscopia digestiva alta e comprovação histopatológica de EB, divididos em dois grupos: EBC e EBL. Foram avaliados os dados demográficos, o tempo de doença, prevalência de hérnia hiatal, dados obtidos à esofagomanometria e pHmetria. Resultados - EBC 46 pacientes (24 masculino 52,2% e média de idade de 55,22 anos), EBL 28 pacientes (18 masculino 64,3% e média de idade 50,5 anos); tempo de sintomas: EBC 9,88 anos e EBL 12,94 anos; hérnia de hiato: EBC 84,2%, EBL 96,3%; pressão média do esfíncter inferior do esôfago: EBC 9,15 mm Hg, EBL 6,99 mm Hg; hipotensão do esfíncter inferior do esôfago: EBC 65,9%, EBL 82,1%; motilidade esofagiana ineficaz (MEI) leve/moderado: EBC 34,8%, EBL 46,4%; MEI acentuado: EBC 5 10,9%, EBL 7,1%; aperistalse: 6,5%, EBL 3,6%; esôfago em quebra-nozes: EBC 8,6%, EBL 0%; corpo normal: EBC 39,1%, EBL 42,9%, sem diferença estatística para qualquer desses valores (P<0,05). Médias de pHmetria: % de tempo total com pH <4: EBC (29/46) 9,12% EBL (15/28) 27,27% P<0,000; % de tempo ereto com pH<4: EBC 11,91%, EBL 24,29% P = 0,003; % de tempo supino com pH <4: EBC 10,86% EBL 33,26% P = 0,000. Conclusões - Não houve diferença entre a prevalência das alterações motoras em pacientes com EBC e EBL. O refluxo ácido, tanto em posição ereta como em posição supina, foi mais intenso no EBL
Disciplines: Medicina,
Demografía
Keyword: Gastroenterología,
Características de la población,
Esófago de Barrett,
Reflujo gastroesofágico,
Manometría,
Trastornos,
Motilidad esofágica
Keyword: Gastroenterology,
Demographics,
Barrett esophagus,
Gastroesophageal reflux,
Manometry,
Disorders,
Esophageal motility
Full text: http://www.scielo.br/pdf/ag/v49n1/11.pdf