Análise histopatológica do esôfago de pacientes com refluxo gastroesofágico com manifestações clínicas típicas e atípicas

Abstract

Introduction: The gastroesophageal reflux disease is the illness with high prevalence in the ocidental world and it appears with typical or atypical symptoms. The most common typical symptoms, present in approximately 50% of the patients are heartburn and acid reflux. Among the atypical symptoms the most studied and divulged are the chest pain, respiratory and otorrinolaringologic manifestations. In general, patients that have atypical symptoms, don’t present visible lesions at endoscopy, suggesting that exists some histologic protection’s factor additional, speccialy in the third part of inferior esophagus. Objective: To investigate the histological findings in the third part of superior, middle and inferior esophagus of the patients porters of GERD that have typical and atypical symptoms of this illness, in relation with volunteers without clinical manifestation of GERD. Methodology: It was accomplished a prospective and longitudinal study in what 30 patients were studied, among these, 20 patients were looked up in particular clinic with the diagnostic of GERD done through twenty-four-hour esophageal pH testing of one channel, and 10 controls without digestive complaints. The patients were divided in 3 groups, group I: 10 patients with typical symptoms of GERD; group II: 10 patients with atypical symptoms of GERD; group III: 10 volunteers without clinical manifestation of GERD. Each group was formed with 5 men and 5 women. All the patients belonged to the age 18 to 45 years old, it was accomplished a esophagogastroduodenoscopy with biopsy of the third part of superior, middle and inferior esophagus, totalizing 3 biopsies for each patient with histological analysis of the material. The criterions analysed were the basal cell hyperplasia, papillary zone elongation, neutrophil and eosinophil infiltration, vascular congestion and hemorrhage. The collected basis were organized in spreadsheet of the Microsoft Excel© 2003 program and, after, submitted to a statistics analysis with the Bioestat© 5.0 program. Results: The unique criterion that had meaningful difference was the basal cell hyperplasia, that was more prevalent in the inferior third part of the esophagus than in the superior and middle part of it (P<0,05; ANOVA). Conclusion: The unique criterion that had meaningful difference was the basal cell hyperplasia, that was more prevalent in the inferior third part of the esophagus than in the superior and middle part of it. It was not observed statistics differences between the groups and the sex of the patients with typical, atypical and without clinical manifestations of GERD related with the following criterions: papillary zone elongation, neutrophil and eosinophil infiltration, vascular congestion and hemorrhage.