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Purpose: We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs). Methods: This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS). Results: Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with Helicobacter pylori (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (p>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (p<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (p<0.02), although poor school performance (p<0.0007) and bullying (p<0.01) were higher in patients with ORGD. Conclusion: This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.

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Introducción: el reflujo laringofaríngeo (RLF) se origina por el flujo retrógrado de contenido gástrico hacia la faringe, pero es una entidad diferente de la enfermedad por reflujo gastroesofágico (ERGE). El objetivo del estudio fue determinar la correlación entre los signos endoscópicos de la fibrolaringoscopia y la videoendoscopia digestiva alta (VEDA). Material y métodos: estudio observacional, retrospectivo y analítico. Se incluyeron pacientes que consultaron por sintomatología de RLF y ERGE. Los hallazgos visualizados por fibrolaringoscopia flexible, VEDA y biopsia de mucosa gástrica de cada paciente se compararon con la prueba de chi-cuadrado (χ²). Se consideró significativo un valor de p ≤ 0,05. Resultados: se incluyeron 318 pacientes entre 18 y 84 años. Se encontró que el 100 % de los pacientes con esofagitis tenía laringitis (p = 0,001); el 100 % de los pacientes con hernia hiatal tenían RLF (p = 0,001); el 97 % de los pacientes con Helicobacter pylori en la mucosa gástrica tenían RLF (p = 0.001). El 71 % de los pacientes con hernia hiatal tenían esofagitis (p = 0,001). Se encontró una asociación lineal entre la edad y la hernia hiatal con la edad y el RLF (p = 0,03). Conclusiones: en este estudio, los signos encontrados en la fibrolaringoscopia tuvieron una asociación estadística con la VEDA. Aproximadamente el 90 % de los pacientes con signos de laringitis tuvo una correlación con algún grado de esofagitis, esófago de Barrett, hernia hiatal y Helicobacter pylori. También se encontró que la laringitis por RLF y la hernia hiatal se relacionaron directamente con el incremento de la edad.

Introduction: Laryngopharyngeal reflux (LPR) is caused by the retrograde flow of gastric contents towards the pharynx, but it is a different entity from gastroesophageal reflux disease (GERD). The objective of the study was to determine the relationship between the endoscopic signs of fiber laryngoscopy and upper gastrointestinal video endoscopy. Material and methods: Observational, retrospective and analytical study. Patients who consulted for LPR and GERD symptoms were included. The findings visualized by flexible fiber laryngoscopy, upper gastrointestinal video endoscopy and gastric mucosal biopsy of each patient were compared with the Chi-square (χ²) test. A value of p ≤ 0.05 is estimated significantly. Results: 318 patients between 18 and 84 years old were included. A relationship was found in 100% of the patients with esophagitis had laryngitis (p = 0.001); 100% of the patients with hiatal hernia had LPR (p = 0.001); 97% of patients with Helicobacter pylori in the gastric mucosal have LPR (p= 0.001); 71% of patients with hiatal hernia had esophagitis (p = 0.001). A linear association was found between age and hiatal hernia with age and LPR. (p = 0.03). Conclusions: In this study, the signs found in fiber laryngoscopy had a statistical association with the upper gastrointestinal video endoscopy. Approximately 90% of patients with signs of laryngitis had correlation with some degree of esophagitis, Barrett's esophagus, hiatal hernia and Helicobacter pylori. It was also found that LPR and hiatal hernia were directly related to increasing age

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Introducción: Enfermedad por reflujo se desarrolla cuando el contenido gástrico provoca síntomas y/o complicaciones esofágicas y extra esofágicas. Las esofágicas incluyen el reflujo, esofagitis de reflujo y el esófago de Barrett. Esta última premaligna, caracterizada por una metaplasia intestinal especializada cuya importancia es el conocimiento de la displasia por su evolución a cáncer. Trabajos anteriores determinaron, displasia en esófago de Barrett 33,3%; prevalencia de enfermedad por reflujo no erosiva 82,70% y erosiva 17,30%; de esofagitis con hallazgo endoscópico e histológico 84,37%. Objetivo: Evaluar la prevalencia del esófago de Barrett por reflujo y esofagitis por reflujo en el Instituto Anatomopatológico de la Universidad Central de Venezuela. Método: Se realizó un estudio descriptivo, retrospectivo. Se estudiaron las muestras endoscópicas de biopsias esofágicas que ingresaron en el período 2005 al 2015, con diagnóstico de reflujo y esofagitis por reflujo. Se evaluó la ausencia o presencia de displasia en el esófago de Barrett, con su gradación correspondiente. Se utilizó un análisis descriptivo presentado en forma de frecuencias absolutas y relativas. Resultados: 35,85% reflujo y 64,12% esofagitis por reflujo, ambas con predominio en mujeres y edad promedio de 55,2 y 53,1 años respectivamente. Dieciocho casos (8%) con esófago de Barrett en relación a enfermedad por reflujo. Displasia de bajo grado 5,55%, indefinido para displasia 50% y negativo para displasia 44,44%. Conclusiones: La prevalencia de esófago de Barrett asociado a enfermedad por reflujo gastroesofágico fue del 8%. La mayor frecuencia fue en el sexo femenino con 66,66%, y las edades comprendidas entre 30 y 78 años con una media de 59,25 años.

Introduction: Reflux disease develops when gastric content causes esophageal and extra esophageal symptoms and/or complications. The esophageal complications include reflux, reflux esophagitis and Barrett's esophagus. The last is a pre-malignant condition characterized by a specialized intestinal metaphase whose importance lies in the knowledge of dysplasia due to its evolution to cancer. Previous investigations determined the prevalence of: dysplasia in Barrett's esophagus 33,3%; non erosive reflux disease 82,70% and erosive 17,30%; esophagitis with endoscopic and morphologic findings 84,37%. Objective: To evaluate the prevalence of Barrett's esophagus in patients with reflux and reflux esophagitis in the Anatomopathologic Institute of Universidad Central de Venezuela. Method: A descriptive and retrospective study was conducted. There were evaluated the esophageal endoscopic biopsies between 2005-2015, with diagnosis of reflux and reflux esophagitis.The presence or absence of dysplasia was reviewed in the Barrett's esophagus cases, with the respective grade. Absolute and relative frequencies were obtained by a descriptive analysis. Results: 35,85% of cases were reflux and 64,12% were reflux esophagitis, both with women predominance and the average age was 55,2 and 53,1 years respectively. Eighteen cases (8%) with Barrett's esophagus were related to reflux disease. Low grade dysplasia represented 5,55%, indefinite for dysplasia 50% and negative for dysplasia 44,44%. Conclusions: The prevalence of Barrett's esophagus associated with gastroesophageal reflux disease was 8%.The highest frequency was in the female sex with 66,66%, and the ages between 30 and 78 years with an average of 59,25 years.

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A doença do refluxo gastroesofágico é o retorno do conteúdo gástrico através do esfíncter esofágico inferior independentemente da sua etiologia, manifestando-se por sintomas (típicos ou atípicos) ou dano tecidual. O diafragma é o principal músculo respiratório e a sua parte crural um dos componentes fundamentais da barreira antirefluxo. As contrações deste são relacionadas às mudanças na pressão da junção esofagogástrica que normalmente são relacionadas com a respiração. Estudos apontamevidências de déficit diafragmático na doença de refluxo gastroesofágico que pode ser melhorado com treinamento diafragmático. A pressão inspiratória máxima é um método simples de avaliar a força inspiratória determinada pelo diafragma. A partir deste contexto, surgiu a hipótese de que os sintomas da doença de refluxo gastro esofágico podem se associar à pressão inspiratória máxima...

The gastroesophageal reflux disease is the return of gastric contents through the lower esophageal sphincter regardless of etiology, manifesting itself by symptoms (typical or atypical) or tissue damage. The diaphragm is the main respiratory muscle and its crural part one of the fundamental components of the antireflux barrier. Contractions of this are related to changes in pressure of the gastroesophageal junction that are usually related to breathing. Studies show evidence of diaphragmatic weaknessin gastroesophageal reflux disease that can be improved with diaphragmatic training. The maximalinspiratory pressure is a simple method to evaluate the inspiratory force determined by diaphragm. From this context, the hypothesis that the symptoms of gastroesophageal reflux disease may be associated with the maximal inspiratory pressure...

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La esofagitis de reflujo, es una entidad clínica que forma parte de la enfermedad de reflujo gastroesofágico (ERGE). A pesar que la endoscopia, tiene una excelente especificidad en 90% - 95%, su sensibilidad es sólo del 50%. Más del 50% de los pacientes con síntomas de ERGE han sido diagnosticados como enfermedad por reflujo no erosivo, (ERNE). El análisis más cuidadoso de los estudios publicados, reporta que la mayoría de los pacientes con ERNE tenían pequeños cambios en la mucosa del esófago distal, específicamente proximal a la línea Z; introduciéndose con estos hallazgos el término de esofagitis de cambios mínimos. Pero también cambios característicos de los bucles capilares papilares intraepiteliales (BCPIE) han sido demostrados, en pacientes con esofagitis de cambios mínimos por ERGE. Evaluar y comparar en pacientes con el diagnóstico de ERNE y en pacientes controles, la alteración morfológica de BCPIE en el esófago distal, con la intención de diagnosticar esofagitis de cambios mínimos, utilizando endoscopios de alta resolución con magnificación, cromoscopia electrónica e imagen espectral FICE. Estudio de corte transversal, prospectivo, con un muestreo no probabilístico, de tipo intencional y grupo control, realizado con pacientes que asistieron a la consulta ambulatoria del servicio de Gastroenterología del Hospital Universitario de Caracas y de la Clínica El Ávila, desde mayo de 2007 a noviembre de 2011. De 156 pacientes con diagnóstico de ERNE y 100 pacientes de grupo control. Grupo control: 100 pacientes, 3 pacientes con BCPIE tipo II (1%). Grupo ERNE 156 pacientes, 5 tenían un patrón: Tipo I considerado normal y 151 tenían un patrón de los BCPIE alterado: 146 con patrón de BCPIE Tipo II (96,68%), sensibilidad 97%, especificidad 97%; 5 (3,31%), tenían un patrón de BCPIE Tipo III sensibilidad 5% y especificidad 0%. Los cambios anatómicos encontrados en los BCPIE de la mucosa del esófago, cuando se hace una endoscopia digestiva...

Reflux esophagitis is a clinical entity that is part of Gastroesophageal Reflux Disease (GERD). Although endoscopy has an excellent specificity of 90% -95%, its sensitivity is only 50%. Over 50% of patients with symptoms of GERD have been diagnosed as non-erosive reflux disease (NERD). More careful analysis of the published studies reported that most NERD patients had minor changes in the distal esophageal mucosa, specifically proximal to the Z line; introducing with these findings the term of Minimal Change Esophagitis. Also changes characteristic of Intra Papillary Epithelial Capillary Loops (BCPIE) have been demonstrated in patients with Minimal Change Esophagitis by GERD. To evaluate and compare patients with the diagnosis of NERD and controls, BCPIE morphological alteration in the distal esophagus, with the intention of diagnosing minimal change esophagitis, using high-resolution magnification endoscopes, electronic and spectral imaging chromoscopy FICE. Prospective, cross-sectional study with a non-probability sampling, intentional kind and control group, of patients attending the outpatient clinic of the Department of Gastroenterology, University Hospital of Caracas and of Avila Clinic, from May 2007 to November 2011. Of 156 patients diagnosed with NERD and 100 patients in the control group. Control group: 100 patients, 3 patients with type II BCPIE (1%). NERD group 156 patients, 5 had a pattern: Type I considered normal and 151 had a pattern of altered BCPIE: 146 BCPIE with a Type II pattern (96, 68%), sensitivity 97%, specificity 97%; 5 (3, 31%), had BCPIE with a Type III pattern Sensitivity 5% and Specificity 0%. The anatomical changes found in BCPIE at the esophageal mucosa, when an endoscopy is performed in patients with GERD, allow the diagnosis of Minimal Change Esophagitis. The BCPIE type II pattern is the most frequently found in Minimal Change Esophagitis. The indication of Endoscopy with high definition magnification....

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La relación entre índice de masa corporal elevados, la presencia de hernia hiatal y síntomas de reflujo han sido ampliamente asociadas al diagnostico de esofagitis por reflujo. Estudios recientes han demostrado la asociación del sobrepeso con la enfermedad de reflujo. En vista de esto nos propusimos realizar este estudio con el objetivo de demostrar la relación de la esofagitis por reflujo anatomopatologicamente diagnosticada asociada al índice de masa corporal calculado por el índice de Quetelet, los hallazgos endoscópicos de esofagitis según la clasificación de los Ángeles, y síntomas de reflujo referidos por los pacientes de la consulta del servicio de gastroenterología del Hospital “Carlos J. Bello” de la Cruz Roja Venezolana. Se tomo una muestra de 32 pacientes los cuales el 100% tienen diagnostico anatomopatologico de esofagitis por reflujo en un periodo comprendido entre noviembre 2009 y abril de 2010, de los cuales 26 eran del sexo femenino representando el 81,25% de la muestra y 6 del sexo masculino representando el 18,75% de la muestra. El 78,12% presentaron Hernia hiatal como diagnostico endoscópico y referían síntomas de reflujo gastroesofagico (Regurgitación y Pirosis). En cuanto al hallazgo endoscópico 56,25% presento diagnostico de esofagitis grado A y el 28,12% esofagitis grado B según la Clasificación de los Angeles. En cuanto al índice de masa corporal 32,5% presento IMC< de 24,99 Kg/mt2; el 35,4% presentó IMC>25 kg/mt2 y < de 29,99 Kg/mt2; y el 32,1% presento IMC> 30 kg/mt2. En conclusión el 67,5% de los pacientes presentaban IMC elevados.

The relation between elevated body mass index, and the presence of hiatal hernia and reflux symptoms had been widely associated with the diagnosis of GERD. Most recently lack of studies had demonstrated the association between overweight and GERD. In regard to this matter we proposed to make an study to demonstrate the relation of esophageal reflux disease diagnose by histopalogic finding and elevated body mass index calculated with the Quetelet index, endoscopic findings of esofaghitis clasificated by the Los Angeles classification, and reflux symptoms referred by the patients on the Consult of the Gastroenterology service from the Carlos J. Bello Hospital, Venezuelan Red Cross. It took a sample of 32 patients 100% of them with histopathology findings of reflux esophagitis taken from a time period between November 2009 to April 2010, distributed in 26 female patients (81,25%) and 6 male patients (18,75%). 78,12% had hiatal hernia, and referred gastro esophageal reflux symptoms (Regurgitation and pyrosis). Regard to Endoscopic findings 56.25% presented grade A esofaghitis, 28,12% Grade B esophagitis. Regard to Body mass index 32,5% presented a BMI: <24.99 Kg/ mt2; 35,4% BMI:>25 Kg/mt 2 and <29,99 Kg/mt2; 32,1% presented BMI>30 Kg/mt2. In conclusion 67,5% presented elevated BMI.

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