Influence of exercise testing in gastroesophageal reflux in patients with gastroesophageal reflux disease.

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. AIM: 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.

Influence of exercise testing in gastroesophageal reflux in patients with gastroesophageal reflux disease / Influencia do teste de esforco no refluxo gastroesofagico em portadores de doenca do refluxo gastroesofagico

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. Aim : 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; ...

Racional : A doença do refluxo gastroesofágico é afecção com elevada prevalência em todo o mundo, que apresenta grande variedade de sinais e sintomas esofagianos ou extra-esofágico, podendo ter entre suas complicações o adenocarcinoma esofágico. Nos últimos anos, maior importância tem sido dada à influência dos exercícios físicos na sua patogênese. Algumas investigações recentes, embora com resultados conflitantes, apontam para agravamento do refluxo gastroesofágico durante eles. Objetivos : Avaliar a influência da atividade física em pacientes com doença erosiva e não erosiva através do teste ergométrico de esforço, e ainda, a relevância do tônus ​​do esfíncter esofagiano inferior e do índice de massa corpórea durante esta situação. Métodos : Vinte e nove pacientes com doença do refluxo erosiva (grupo I) e 10 com não-erosiva (grupo II) foram avaliados prospectivamente. Todos foram submetidos à avaliação clínica, seguida pela endoscopia digestiva alta, manometria e pH-metria esofágica de 24 horas. Um teste ergométrico foi realizado uma hora antes de retirar a sonda de pH-metria. Durante ele as seguintes variáveis ​​foram analisadas: eficácia do teste, o consumo máximo de oxigênio ou VO2 max, tempo de refluxo ácido, sintomas de refluxo gastroesofágico, influência do tônus ​​do esfíncter esofágico e do índice de massa corporal na ocorrência de refluxo gastroesofágico durante esta situação. Resultados : VO2 max apresentou correlação significativa, quando foi maior ou igual a 70%, apenas no grupo doença erosiva, avaliando os pacientes com ou sem refluxo ácido durante o teste ergométrico ...