Doença do refluxo gastroesofágico e sua relação com a asma

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18 Rev. bras. alerg. imunopatol. – Vol. 30, Nº 1, 2007 RGE e asma na área pediátrica têm mostrado resultados se- Estudos (tabela 3). Após o tratamento de crianças e melhantes asmáticos com DRGE, utilizando tratamento adolescentes (bloqueador H2, agente procinético, mudança do clínico hábito de vida ou uma associação de medicações) ou trata- cirúrgico, esses pacientes apresentaram redução do mento de sintomas noturnos escore 63 sintomas pulmona- , res 32,56,57,63 menor necessidade de medicação para as- , ma 32,56,57 melhora dos índices da pHmetria intra-esofági- e Tabela 3 - Ensaios clínicos de terapia anti-refluxo gastroesofágico e resposta terapêutica em pacientes pediátricos asmáticos Autores (ano) et al Andze (1991) et al Gustafsson (1992) et al Tucci (1993) et al Khoshoo (2003) Tratamento (duração) proposto clínico* ou cirúrgico Ranitidina semanas) (4 Cisaprida meses) (3 (Cisaprida ou clínico / Metoclopramida) cirúrgico ca 47 . de Número pacientes 105 Resposta terapêutica tratamento clínico 69% tratamento cirúrgico 27% melhora dos sintomas e redução de - medicações 37 30% redução dos sintomas noturnos 11 (clínico) 18 (cirúrgico) 9 redução dos sintomas e de uso de 81,8% medicações 50% redução do uso de medicações * tratamento clínico: medidas posturais, dieta, medicamentoso (metoclopramida, cisaprida, domperidona e /ou antiácidos). relação entre doença do refluxo gastroesofágico e as- A ainda não está plenamente conhecida. Os estudos reama mostram alta prevalência de RGE lizados 47,56,57 pacien- em com asma grave ou moderada, ou ainda naqueles clastes como portadores de asma de difícil controle. Estes sificados sugerem uma possível contribuição do RGE no de- estudos ou na exacerbação dos sintomas da asma, sencadeamento alguns ensaios clínicos mostram a melhora dos sinto- pois da asma ou redução do uso de medicação durante e mas o tratamento da DRGE após 57,65 . disso, alguns estudos tentam estabelecer os meca- Além que levam a broncoconstrição, pela sensibilização nismos ao ácido em esôfago distal esofágica 28,43,59 aspiração do ou gástrico conteúdo 60-62 . conclusão, nesta revisão foram abordados os princi- Em mecanismos patofisiológicos que decorrem da presenpais da DRGE, os métodos laboratoriais disponíveis para a ça investigação, bem como os questionamentos sobre os sua mesmos. Referências Orenstein SR, Izadnia F, Khan S. Gastroesophageal reflux di- 1. in children. 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Doença do refluxo gastroesofágico e sua relação com a asma

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