Estudo de associações entre pressão inspiratória máxima e sintomas da doença do refluxo gastroesofágico

Abstract

Gastroesophageal Reflux Disease (GERD) is defined as a chronic disease related to the retrograde flow of gastroduodenal content towards the esophagus and adjacent organs, resulting in a variable spectrum of symptoms, with or without tissue injury. It has an estimated global prevalence of 8% to 33%, involving all age groups and both sexes. Its pathophysiology is related to a failure of the antireflux barrier (BAR), which is basically formed by the lower esophageal sphincter (IES), the crural diaphragm (DC) and the brainsophageal ligament. Many studies have shown that the crural diaphragm assumes a fundamental role in the antireflux barrier, increasing the pressure at the esophagogastric junction (JEG). Some studies evidenced a crural deficit in patients with GERD symptoms through high resolution manometry (MAR). Objective: Correlate GERD symptoms with maximal inspiratory pressure (MIP), tracking crural deficit through manovacuometry. Method: Cross-sectional study in humans, performed at the Laboratory of Research and Gastroenterology (LabGastro) of the Faculty of Medicine of the UFC and in the Endoscopy Service of the HUWC-UFC, from July 2016 to July 2018. The sample was composed of 164 selected patients in the endoscopy queue at the Walter Cantídio University Hospital (HUWC-UFC), who underwent a clinical evaluation with anthropometric data and symptom questionnaires and the manovacuometry examination. Results: Data analysis revealed that the atypical symptoms of GERD (evaluated by the RSI questionnaire) showed a significant inverse correlation with the MIP (p = 0.029), age and weight were not correlated with symptoms, but height was inversely correlated with the RSI score (p = 0.023). Age did not correlate with MIP. Weight and height correlated directly with MIP. Conclusions: MIP is not associated with esophagitis, the atypical symptoms of GERD are associated with poor MIP and most GERD symptoms are equally present among patients with and without esophagitis.