A investigação da refratariedade na Doença do Refluxo Gastroesofágico / The investigation of refractoriness in Gastroesophageal Reflux Disease

João Nivaldo Sampaio Novaes Júnior, Ana Carolina da Rocha Maranhão, Henrique Lopes Vieira Santos, Isadora Rollemberg Caldas Menezes, Laura Boueri Ticle Lima, Marianne Borges Freitas, Nathália de Souza Teixeira

Abstract


Introdução: A Doença do refluxo gastroesofágico (DRGE) consiste em uma afecção crônica cuja droga de escolha para o tratamento é o inibidor de bomba de prótons (IBP). Pacientes com DRGE e resposta parcial ou sem resposta ao uso de IBP em dose otimizada são portadores de DRGE refratária. O objetivo deste artigo é discutir causas, quadro clínico, diagnóstico e diagnósticos diferenciais da DRGE refratária. Metodologia: Trata-se de uma revisão literária com análise de dados da National Library of Medicine (PubMed) utilizando os descritores: “Gastroesophageal Reflux Disease”, “prevalence”, “Proton Pump Inhibitor” e “Treatment Failure”. Resultados: Foram selecionados 20 estudos publicados entre 2012 e 2021, consistindo em coorte retrospectivo, multicêntrico, artigo de opinião, ensaio clínico e artigos de revisão. Discussão: A DRGE é caracterizada por sintomas e/ou complicações relacionadas à presença de refluxo do conteúdo gástrico no esôfago. As manifestações clínicas são divididas em sintomas típicos, atípicos e formas complicadas. Diante da suspeita de DRGE é realizada prova terapêutica aliado a medidas comportamentais. Pacientes refratários ao uso de IBP necessitam de investigação minuciosa, principalmente para avaliar os principais diagnósticos diferenciais. Conclusão: Nos casos de DRGE refratária é importante realizar um diagnóstico correto para um manejo e tratamento eficazes.


Keywords


Refluxo Gastroesofágico, Inibidores da Bomba de Prótons, Esôfago de Barret, Azia, sintomas refratários.

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DOI: https://doi.org/10.34119/bjhrv4n5-211

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