RESUMO
BACKGROUND: The most prevalent stomach infection in the world is caused by Helicobacter pylori (H. pylori). Several pathogenicity genes, including cagA, vacA, babA2, dupA, iceA, and oipA, are associated with an increased risk of gastrointestinal disease such as peptic ulcer and stomach cancer. This research aims to determine the prevalence of different H. pylori genotypes and correlate their risk in the development of gastrointestinal diseases in the Ecuadorian population. METHODS: A cross-sectional research of 225 patients at the Calderón Hospital in Quito, Ecuador, was conducted. End point PCRs were run to determine the presence of 16S rRNA, cagA, vacA (m1), vacA (s1), babA2, dupA, iceA1, and oipA virulence genes. Chi-square test, odds ratios (OR) and 95% confidence intervals (CI) were utilized for the statistical analysis. RESULTS: H. pylori infection was present in 62.7% of people. Peptic ulcers were seen in 22.2% and malignant lesions in 3.6% of patients. Genes oipA (93.6%), vacA (s1) (70.9%), and babA2 (70.2%) were the most prevalent. cagA/vacA (s1m1) and cagA/oipA (s1m1) combinations were found in 31.2% and 22.7% of the cases, respectively. Acute inflammation has a significant correlation with the genes cagA (OR = 4.96 95% CI: 1.1-22.41), babA2 (OR = 2.78 95% CI: 1.06-7.3), and the cagA/oipA combination (OR = 4.78, 95% CI: 1.06-21.62). Follicular hyperplasia was associated with iceA1 (OR = 3.13; 95% CI: 1.2-8.16), babA2 (OR = 2.56; 95% CI: 1.14-5.77), cagA (OR = 2.19; 95% CI: 1.06-4.52), and the cagA/oipA combination (OR = 2.32, 95% CI: 1.12-4.84). The vacA (m1) and vacA (s1m1) genes were associated with gastric intestinal metaplasia (OR = 2.71 95% CI: 1.17-6.29) (OR = 2.33 95% CI: 1.03-5.24). Finally, we showed that cagA/vacA (s1m1) gene combination increased the risk of duodenal ulcer development (OR = 2.89, 95% CI 1.10-7.58). CONCLUSION: This study makes a significant contribution by offering genotypic information regarding H. pylori infection. The presence of several H. pylori genes was associated with the onset of gastrointestinal illness in the Ecuadorian population.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Úlcera Péptica , Neoplasias Gástricas , Humanos , Proteínas de Bactérias/genética , Adesinas Bacterianas/genética , Antígenos de Bactérias/genética , Helicobacter pylori/genética , Estudos Transversais , Proteínas da Membrana Bacteriana Externa/genética , Equador/epidemiologia , Prevalência , RNA Ribossômico 16S , Úlcera Péptica/epidemiologia , Úlcera Péptica/complicações , Genótipo , Neoplasias Gástricas/complicações , Infecções por Helicobacter/complicaçõesRESUMO
BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%). CONCLUSION: Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.
Assuntos
Hemorragia Gastrointestinal , Úlcera Péptica , Idoso , Hemorragia Gastrointestinal/epidemiologia , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Úlcera Péptica/complicações , Úlcera Péptica/epidemiologia , Estudos Prospectivos , Encaminhamento e Consulta , Centros de Atenção TerciáriaRESUMO
ABSTRACT BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions. OBJECTIVE: To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease. METHODS: Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period. RESULTS: A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%). CONCLUSION: Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.
RESUMO CONTEXTO: A hemorragia digestiva alta não varicosa (HDANV) secundária à úlcera péptica é uma emergência médica digestiva e pode ser uma reação adversa a medicamento severa. OBJETIVO: Estimar a frequência de HDANV secundária à doença péptica. MÉTODOS: Estudo prospectivo e epidemiológico realizado em um hospital brasileiro terciário de referência, no período de julho de 2016 a dezembro de 2019. Os laudos de endoscopia gastrointestinal alta foram avaliados diariamente. O diagnóstico de HDANV secundária para úlcera péptica foi definido por achados endoscópicos de úlcera péptica e lesões gástricas erosivas e sintomas clínicos. A frequência de diagnóstico de HDANV secundária à úlcera péptica foi estimada por meio da razão entre o número de pacientes diagnosticados e o número de pacientes submetidos à endoscopia gastrointestinal alta no mesmo período. RESULTADOS: Um total de 2.779 laudos endoscópicos (2.503 pacientes) foram avaliados e 178 pacientes foram elegíveis. A frequência total de diagnóstico de HDANV secundária à úlcera péptica foi de 7,1%. A frequência anual de diagnósticos entre 2017 e 2019 variou de 9,3% a 5,7%. A maioria dos pacientes era do sexo masculino (72,8%); auto-declarado branco (71,8%); idoso (56,7%); e não possuía histórico familiar ou pessoal de doenças gastrointestinais (60,1%). 90% dos pacientes apresentaram úlcera péptica e melena (62,8%). Os pacientes faziam uso crônico de ácido acetilsalicílico como antiagregante plaquetário (29,3%), outros antiplaquetários (21,9%) e anticoagulantes orais (11,2%); e fizeram uso e uso de anti-inflamatórios não esteroidais na semana anterior ao início dos sintomas clínicos de HDANV (25,8%). CONCLUSÃO: Cerca de sete em cada 100 pacientes admitidos em um hospital terciário e submetidos à endoscopia gastrointestinal alta foram diagnosticados com HDANV secundária à úlcera péptica.
Assuntos
Humanos , Masculino , Úlcera Péptica/complicações , Úlcera Péptica/epidemiologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/epidemiologia , Encaminhamento e Consulta , Estudos Prospectivos , Centros de Atenção TerciáriaRESUMO
Peptic ulcer disease (PUD) is a multifactorial and complex disease caused by an imbalance of protective and aggressive factors (endogenous and exogenous). Despite advances in recent years, it is still responsible for substantial mortality and triggering clinical problems. Over the last decades, the understanding of PUD has changed a lot with the discovery of Helicobacter pylori infection. However, this disease continues to be a challenge due to side-effects, incidence of relapse from use of various anti-ulcer medicines, and the rapid appearance of antimicrobial resistance with current H. pylori therapies. Consequently, there is the need to identify more effective and safe anti-ulcer agents. The search for new therapies with natural products is a viable alternative and has been encouraged. The literature reports the importance of monoterpenes based on the extensive pharmacological action of this class, including wound healing and anti-ulcerogenic agents. In the present study, 20 monoterpenes with anti-ulcerogenic properties were evaluated by assessing recent in vitro and in vivo studies. Here, we review the anti-ulcer effects of monoterpenes against ulcerogenic factors such as ethanol, nonsteroidal anti-inflammatory drugs (NSAIDs), and Helicobacter pylori, highlighting challenges in the field.
Assuntos
Monoterpenos/farmacologia , Úlcera Péptica/tratamento farmacológico , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/patogenicidade , Humanos , Monoterpenos/metabolismo , Úlcera Péptica/epidemiologia , Úlcera Péptica/etiologia , Fatores de RiscoRESUMO
OBJECTIVE: Perform a prospective study based on sequential clinical, endoscopic, and histologic evaluations of the foregut late after laparoscopic sleeve gastrectomy (LSG) in obese patients. After LSG, several studies have suggested an increase in the incidence of clinical gastroesophageal reflux (GERD) while others have reported an improvement but based mainly on clinical questionnaires. METHODS: Prospective study of 104 consecutive patients submitted to LSG. Several postoperative endoscopic and histologic evaluations of the esophagogastric junction (EGJ) and the gastric tube (GT) were performed and correlated with symptomatic findings. RESULTS: According to clinical preoperative findings, patients were divided into non-refluxers (Group I) and refluxers (Group II). Seven patients were unreachable, leaving 97 (93%) for late evaluation. Among Group I, 58.5% developed de novo GERD, while in Group II just 13.6% showed the disappearance of them. Endoscopic evaluations showed progressive deterioration of the EGJ in Group I, with the development of erosive esophagitis (EE), hiatal hernia (HH), and dilated cardia in a large proportion of them. In the GT, the presence of bile was seen in 40%, and an open immobile pylorus was detected in 82%. Short-segment Barrett's esophagus (BE) appeared in 4%. CONCLUSIONS: Patients submitted to LSG showed a significant and progressive increase in the presence of "de novo" GERD. Also, an increased duodenogastric reflux was seen through an open and immobile pylorus. Therefore, based on these results, it seems like LSG is a "pro-reflux" surgical procedure, which should be continuously evaluated late after surgery.
Assuntos
Endoscopia Gastrointestinal , Doenças do Esôfago/epidemiologia , Gastrectomia , Técnicas Histológicas , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Gastropatias/epidemiologia , Adolescente , Adulto , Esôfago de Barrett/diagnóstico , Esôfago de Barrett/epidemiologia , Esôfago de Barrett/etiologia , Esôfago de Barrett/cirurgia , Comorbidade , Endoscopia Gastrointestinal/métodos , Endoscopia Gastrointestinal/estatística & dados numéricos , Doenças do Esôfago/diagnóstico , Doenças do Esôfago/etiologia , Doenças do Esôfago/cirurgia , Esofagite/diagnóstico , Esofagite/epidemiologia , Esofagite/etiologia , Esofagite/cirurgia , Feminino , Seguimentos , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Gastrectomia/estatística & dados numéricos , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Hérnia Hiatal/diagnóstico , Hérnia Hiatal/epidemiologia , Hérnia Hiatal/etiologia , Hérnia Hiatal/cirurgia , Técnicas Histológicas/métodos , Técnicas Histológicas/estatística & dados numéricos , Humanos , Incidência , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/diagnóstico , Úlcera Péptica/diagnóstico , Úlcera Péptica/epidemiologia , Úlcera Péptica/etiologia , Úlcera Péptica/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Período Pré-Operatório , Estudos Prospectivos , Gastropatias/etiologiaAssuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Úlcera Péptica/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Inibidores da Bomba de Prótons/administração & dosagem , Pantoprazol/administração & dosagem , Hemorragia Gastrointestinal/prevenção & controle , Anticoagulantes/efeitos adversos , Úlcera Péptica/induzido quimicamente , Úlcera Péptica/epidemiologia , Esquema de Medicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Método Duplo-Cego , Administração Oral , Estudos Multicêntricos como Assunto , Resultado do Tratamento , Relação Dose-Resposta a Droga , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/epidemiologia , Anticoagulantes/administração & dosagemRESUMO
OBJETIVO: Determinar se características da dor epigaÌstrica saÌo capazes de identificar pacientes com doença ulcerosa peÌptica. MÉTODOS: Estudo caso-controle, com coleta de dados de setembro de 2014 a junho de 2016. Foram incluídos pacientes com mais de 18 anos com dispepsia que realizaram endoscopia digestiva alta ambulatorialmente. Os pacientes foram abordados antes de realizar a endoscopia digestiva alta, verificando, em suas guias, a presença de dispepsia, tendo sido convidados a responder um questionário, e, posteriormente, o prontuário de cada entrevistado foi avaliado para verificação do diagnóstico, sendo, então, divididos entre o Grupo Doença Ulcerosa PeÌptica (casos), com 32 pacientes, e o Grupo Controle, com 44 pacientes com dispepsia atribuída a outras causas. RESULTADOS: Dos pacientes com dispepsia não ulcerosa, 52,27% caracterizaram a dor como em queimação, sendo 47,72% moderada e que piorava com alimentação. Dentre os demais sintomas, 45,45% relataram náuseas e 25% desconforto pós-prandial, com 52,27% relatando histórico familiar negativo de doença ulcerosa peÌptica. Em contrapartida, dos pacientes com doença ulcerosa peÌptica, 53,12% referiram dor em queimação e de moderada intensidade, e 50% relataram piora com alimentação. Dentre os demais sintomas, prevaleceram também náuseas (53,12%) e desconforto pós-prandial (40,62%). A maioria (81,25%) relatou histórico familiar de doença ulcerosa peÌptica. Observou-se diferença estatística em dor noturna, predominando na doença ulcerosa peÌptica (p=0,0225) e dor em cólica na dispepsia não ulcerosa (p=0,0308), assim como na ausência de histórico familiar entre os pacientes com dispepsia não ulcerosa (p=0,0195). CONCLUSÃO: A dispepsia relacionada à doença ulcerosa peÌptica relaciona-se, principalmente, à piora noturna, sendo que a intensidade da dor, a relação com alimentação e os sintomas associados não auxiliaram na diferenciação da dispepsia não ulcerosa, diferentemente do que a literatura tradicionalmente informa. (AU)
To determine whether it is possible to identify Peptic Ulcer Disease through the characteristics of epigastric pain. METHODS: This is a case-control study with data collected between September 2014 and June 2016 including patients over 18 years of age with dyspepsia who underwent upper gastrointestinal endoscopy as outpatients. The patients were approached before the upper gastrointestinal endoscopy when their test requisition form indicated the presence of dyspepsia. The subjects were invited to answer a questionnaire and, afterwards, the records of all interviewees were evaluated to check for the diagnosis. Then, they were divided into a peptic ulcer disease group (cases), with 32 patients, and a control group, with 44 patients with dyspepsia from other causes. RESULTS: Among non-ulcer dyspepsia patients, 52.27% described the pain as a "burning pain", with 47.72% reporting it as moderate and aggravated by food intake. As for other symptoms, 45.45% of subjects reported nausea, and 25% reported postprandial discomfort; 52.27% had no family history of peptic ulcer disease. In contrast, 53.12% of peptic ulcer disease patients reported "burning" and moderate pain, and 50% said the pain was aggravated by eating. As for the other symptoms, nausea (53.12%) and postprandial discomfort (40.62%) prevailed; most of the patients (81.25%) had family history of peptic ulcer disease. There was a statistical difference in night pain, which was more prevalent in peptic ulcer disease (p=0.0225), and colicky pain, which was more frequent in nonulcer dyspepsia (p=0.0308), as well as absence of family history in non-ulcer dyspepsia patients (p=0.0195). CONCLUSION: Dyspepsia caused by peptic ulcer disease is mainly related to night worsening, and pain intensity, the relationship with food intake, and associated symptoms did not help differentiate nonulcer dyspepsia, differently from what the medical literature traditionally suggests. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Úlcera Péptica/diagnóstico , Dispepsia/diagnóstico , Úlcera Péptica/epidemiologia , Pólipos/diagnóstico , Transtornos de Deglutição/diagnóstico , Varizes Esofágicas e Gástricas/diagnóstico , Estudos de Casos e Controles , Cólica/diagnóstico , Inquéritos e Questionários/estatística & dados numéricos , Endoscopia do Sistema Digestório , Helicobacter pylori/isolamento & purificação , Dispepsia/classificação , Dispepsia/epidemiologia , Exacerbação dos Sintomas , Gastrite Atrófica/diagnóstico , Azia/diagnóstico , Hérnia Hiatal/diagnóstico , Anamnese/estatística & dados numéricos , Náusea/diagnósticoRESUMO
Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. METHODS: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers' self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.
Assuntos
Dor Facial/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Dor Facial/fisiopatologia , Feminino , Gastrite/complicações , Gastrite/epidemiologia , Gastrite/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/fisiopatologia , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/fisiopatologia , Cervicalgia/epidemiologia , Cervicalgia/fisiopatologia , Úlcera Péptica/epidemiologia , Úlcera Péptica/fisiopatologia , Prevalência , Fatores Sexuais , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto JovemRESUMO
Resumen Desde el descubrimiento de Helicobacter pylori como agente infeccioso patógeno en el ser humano se ha ligado con diferentes enfermedades gástricas en el ser humano (úlcera péptica, adenocarcinoma gástrico y linfoma MALT). En los últimos años se ha encontrado además su potencial relación etiológica con enfermedades extradigestivas, tales como la anemia por deficiencia de hierro y la púrpura trombocitopénica inmune. El entendimiento de los mecanismos de defensa del huésped así como los factores de virulencia y patogenicidad de la bacteria ha permitido establecer indicaciones en las que la erradicación mediante antibióticos brinda un beneficio clínico, principalmente para las enfermedades gástricas. Recientemente ha aparecido creciente evidencia del beneficio de esta terapia en otras condiciones digestivas y no digestivas e incluso se ha demostrado un potencial impacto con la estrategia de tamizaje y erradicación poblacional de la bacteria para enfermedades de alta morbimortalidad como el cáncer gástrico. El aumento de la utilización de terapia antimicrobiana ha ido de la mano de la emergencia de la resistencia a los antibióticos empleados, lo cual acarrea un problema de salud pública. Esta revisión temática pretende actualizar los conceptos biológicos y clínicos de la infección y demostrar que esta infección aun debe considerarse como emergente.
Abstract Since the discovery of Helicobacter pylori as a pathogenic infectious agent in humans, it has been linked to different gastric diseases in humans (peptic ulcer, gastric adenocarcinoma and MALT lymphoma). In recent years, its potential etiological relationship with extradigestive diseases has also been found, such as iron deficiency anemia and immune thrombocytopenic purpura. The understanding of the host defense mechanisms as well as the virulence and pathogenicity factors of the bacteria has allowed us to establish indications in which antibiotic eradication provides a clinical benefit, mainly for gastric diseases. Recently there has been growing evidence of the benefit of this therapy in other digestive and non-digestive conditions and has even shown a potential impact with the population's screening and eradication strategy of the bacteria for diseases of high morbidity and mortality such as gastric cancer. The increase in the use of antimicrobial therapy has gone hand in hand with the emergence of resistance to the antibiotics used, which leads to a public health problem. This thematic review aims to update the biological and clinical concepts of the infection and demonstrate that this infection should still be considered as emerging.
Assuntos
Fatores Epidemiológicos , Helicobacter pylori , Doenças Transmissíveis Emergentes , Farmacorresistência Bacteriana , Úlcera Péptica/epidemiologia , Neoplasias Gastrointestinais/epidemiologiaRESUMO
Abstract Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. Methods: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers' self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.