Importancia del diagnóstico temprano en pacientes con enfermedad por reflujo gastroesofágico para detección oportuna de esófago de Barrett

Abstract

Introduction. Gastroesophageal reflux disease (GERD) is caused by chronic exposure to pathological reflux of gastric contents into the esophagus. It is one of the most frequent causes of gastroenterological consultation and the main clinical manifestations are heartburn and regurgitation. The main risk factors are age between 45-55 years, female sex, habits such as alcohol and tobacco consumption, obesity, infections related to Helicobacter pylori and gastritis. Objective: Collect necessary information on gastroesophageal reflux disease in order to present relevant information on the need to identify risk factors that allow preventing the progression of GERD to Barrett's esophagus. Materials and methods. A systematic search of electronic databases was performed to identify publications related to early diagnosis of gastroesophageal reflux disease and risk factors for progression to Barrett's esophagus. In the search, 1,680 results were obtained, of which a total of 25 bibliographic references were used, including international guides, which met the inclusion criteria. Results. GERD predisposes to the appearance of cylindrical epithelium in the distal esophagus with the presence of gastric or intestinal metaplasia, being the main trigger factor for a percentage of patients to develop Barrett's esophagus, being the only premalignant lesion that predisposes to the development of esophageal adenocarcinoma ; representing a risk of progression of approximately 0.3-0.6% per year, with a prevalence of GERD of 15% worldwide, 11.9-31.3% in Latin America and in Ecuador it is up to 52.8 %. The classic symptoms are: heartburn that occurs in up to 95% of patients and acid regurgitation that can occur in up to 70% of patients, dysphagia, odynophagia, esophagitis and chest pain may also appear. Conclusions: GERD represents the most frequent reason for gastroenterological consultation and that when presenting classic specific symptoms, it is vitally important to identify early from the first level of care said symptoms and their predisposing risk factors, in order to provide timely treatment that avoid chronic exposure of the esophageal epithelium to reflux of gastric contents; this being the main cause of progression towards Barrett's esophagus, which represents the only predisposing premalignant lesion for the development of esophageal adenocarcinoma.