RESUMO
Introduction: Gastroesophageal reflux disease (GERD) is a highly prevalent condition in the Western world. It is a frequent cause of medical appointments and has a high impact on quality of life (QOL). This study aimed to assess health-related quality of life (HQ-QOL) of patients with non-erosive gastroesophageal disease (NERD) and compare their scores with the scores of patients with GERD symptoms and non-pathological acid reflux (non-NERD). Methods: We studied 42 patients with GERD symptoms21 with positive pHmetry for acid reflux (NERD group) and 21 with negative pHmetry for acid reflux (non-NERD group). We enrolled patients matched by age and gender. Patient inclusion criteria were based on clinical and endoscopic findings and pHmetry. All other major diseases having an impact on QOL were excluded as well as patients in regular use of proton pump inhibitors, prokinetics, histamine-2 receptor antagonists and anti-depressants. All subjects were asked to fill in a validated translation of the SF-36 questionnaire. We described scores trough median and interquartile range (IQR) and assessed the significance of the comparisons through Mann-Whitney test and chi-square test or Student's t-test when appropriate. Results: We found no significant differences in the eight domains of SF-36 between the two groups. Conclusion: QOL of patients with GERD symptoms was equivalent, regardless of acid reflux at pHmetry (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Refluxo Gastroesofágico/psicologia , Qualidade de Vida , Refluxo Gastroesofágico/complicações , Azia/complicações , Azia/psicologia , Índice de Gravidade de Doença , Sinais e Sintomas Digestórios , Avaliação de SintomasRESUMO
OBJECTIVES: Pain in the orofacial region is frequently reported by patients in dental and medical offices. Facial pain, headache, masticatory abnormalities and other complaints often become chronic and may be associated with local disturbances, such as xerostomia and teeth abnormalities. The objective of this study was to investigate salivary flow and xerostomia in patients with orofacial pain. DESIGN: This was a case-control study; we evaluated 82 patients with chronic orofacial pain compared with 56 healthy subjects using a Clinical Pain Questionnaire (pain characteristics, duration, intensity and descriptors), complete dental examination (including static and dynamic evaluation of the jaw) and a Xerostomia Inventory. The salivary flow was quantitatively evaluated. Data was compared through Pearson's chi-square, Fisher's exact, analysis of variance (ANOVA) 1 factor and Mann-Whitney tests. RESULTS: Patients often had temporomandibular disorder (TMD) (P=0.001) and pain during facial (P<0.001) and neck palpation (P=0.002). There were no differences in dental examination or other structural aspects of the jaw between the groups. There were more complaints associated with xerostomia in the study group, including burning sensation in the oral mucosa (P=0.003), in the throat (P=0.035) and in the stomach (P=0.050). Patients had lower salivary flow (P=0.008). CONCLUSIONS: Orofacial pain patients need to be evaluated with regard to their salivary function, which was often found abnormal in this sample and may have contributed to the complaints of these patients. Assessing salivary flow and xerostomia may help in the treatment of chronic orofacial pain.
Assuntos
Dor Facial/complicações , Saliva/metabolismo , Xerostomia/complicações , Antidepressivos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Síndrome da Ardência Bucal/complicações , Estudos de Casos e Controles , Dor Facial/fisiopatologia , Feminino , Azia/complicações , Humanos , Masculino , Mastigação/fisiologia , Fadiga Muscular/fisiologia , Cervicalgia/complicações , Medição da Dor , Faringite/complicações , Taxa Secretória/fisiologia , Distúrbios do Paladar/complicações , Transtornos da Articulação Temporomandibular/complicações , Fatores de Tempo , Neuralgia do Trigêmeo/complicaçõesRESUMO
BACKGROUND: Non-cardiac chest pain (NCCP) is defined by recurrent episodes of substernal chest pain non related to ischemic heart disease, it's origin being in many cases the gastrointestinal tract; however, it may be associated to psychosomatic disorder. OBJECTIVES: To investigate the main causes of NCCP and to evaluate associated psychiatric comorbidity. METHODS: Patients with NCCP referred by a cardiologist were assessed underwent an upper endoscopy, ambulatory pH monitoring and stationary esophageal manometry. NCCP was considered gastro esophageal reflux disease (GERD) positive when the endoscopy and/or ambulatory pH monitoring were abnormal. When all results were normal, the symptom was considered as a functional chest pain (FCP). Patients were assessed by the Psychiatry service and diagnosed in accordance to the Diagnostic and Statistics Manual of Mental Diseases, fourth edition (DSM-IV). Several other test were applied for the assessment of anxiety and depression. RESULTS: Thirty-four patients were included (25 women and nine men; average age: 46.2 +/- 11.56 years). Three patients were eliminated because of refusal of the psychiatric evaluation. In 21 (68%) patients, NCCP was GERD-positive and in 10 (32%) to FCP. The most common symptoms associated to chest pain were: heartburn in 23 (74%), regurgitation in 21 (68%) and dysphagia in 15 (48%) patients. Upper endoscopy was abnormal in four cases; ambulatory pH monitoring was abnormal in 21 (67.7%) patients. The frequency of psychiatric disorders related to NCCP was 52%, in 10 patients with GERD-positive (48%) and six patients with FCP (60%). Mayor depression was the most common diagnoses identified among both groups. CONCLUSION: The high frequency of GERD and psychiatric disorders found in NCCP supports the multidisciplinary approach to NCCP.
Assuntos
Dor no Peito/etiologia , Transtornos de Deglutição/complicações , Refluxo Gastroesofágico/complicações , Azia/complicações , Transtornos Mentais/complicações , Transtornos Psicofisiológicos/diagnóstico , Adulto , Idoso , Dor no Peito/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Monitoramento do pH Esofágico , Feminino , Refluxo Gastroesofágico/diagnóstico , Humanos , Masculino , Manometria , Transtornos Mentais/diagnóstico , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The protective role of Helicobacter pylori in gastro-oesophageal reflux disease has been widely discussed. AIM: To assess the risk of reflux oesophagitis in patients with functional dyspepsia after treatment for H. pylori infection. METHODS: A randomized, placebo-controlled, investigator-blinded trial was carried out on 157 functional dyspeptic patients. Patients were randomized to receive lansoprazole, amoxicillin and clarithromycin (antibiotic group) or lansoprazole and identical antibiotic placebos (control group). Upper gastrointestinal endoscopy was performed at baseline, 3 and 12 months after randomization. The primary aim was to detect the presence of reflux oesophagitis. Analyses were performed on an intention-to-treat basis. RESULTS: A total of 147 patients (94%) and 133 (85%) completed 3 months and 12 months follow-up, respectively. The eradication rate of H. pylori was 90% in the antibiotic group (74 of 82) and 1% (one of 75) in the control group. At 3 months, reflux oesophagitis was diagnosed in 3.7% (three of 82) in the antibiotic group and 4% (three of 75) in the control group (P > 0.2). At 12 months, diagnosis was established in five new cases within the first group and in four within the second (P > 0.2). No difference was found in heartburn symptoms. CONCLUSIONS: H. pylori eradication does not cause reflux oesophagitis in this western population of functional dyspeptic patients.