Correlación clínica del reflujo gastroesofágico y su enfermedad derivada en pacientes de 0 a 12 meses en el Hospital Francisco de Ycaza Bustamante 2008-2011
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2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El reflujo gastroesofágico en niños menores de un año representa una manifestación del proceso fisiológico de maduración del tracto gastrointestinal superior durante los primeros meses de vida. En caso de considerarse patológico es una entidad con múltiples manifestaciones clínicas en el niño las cuales varían de acuerdo a la edad y por su severidad llegar a poner en peligro la vida. Es difícil, identificar a los lactantes que pudieran tener patología que se acompaña de signos sutiles de reflujo gastroesofágico, diferenciación que es esencial para no someter a los lactantes sanos a métodos de investigación onerosos y que pueden entrañar agresividad e invasión corporal. El tratamiento médico del reflujo gastroesofágico patológico se fundamenta en: terapia postural, manejo dietético, tratamiento farmacológico. El tratamiento quirúrgico se basa en: restaurar el segmento intraabdominal del esófago, restablecer el ángulo de His y crear un mecanismo de válvula a nivel de la unión esofagogástrica. Este estudio se realizó en el área de Gastroenterología del Hospital del Niño Francisco de Icaza Bustamante. Tiene como objetivo determinar la correlación clínica entre el reflujo gastroesofágico fisiológico y la enfermedad por reflujo gastroesofágico en niños menores de un año que acuden a consulta externa del Hospital del Niño Francisco de Icaza Bustamante 2008 – 2011. Su metodología es de tipo descriptivo – correlacional con diseño no experimental, longitudinal, retrospectivo. Los resultados muestran que la sintomatología clínica observada corresponden a reflujo y vómitos con 44%, pirosis y disfagia 35% y tos, apnea obstructiva 21%. El 64% de las manifestaciones clínicas en lactantes se presentaban por Reflujo gastroesofágico fisiológico, el 36% se debía a la Enfermedad por Reflujo gastroesofágico.
Gastroesophageal reflux in children under one year is a manifestation of the physiological process of maturation of the upper gastrointestinal tract during the first months of life. If disease is considered an entity with multiple clinical manifestations in children which vary according to age and severity reaching life threatening. It is difficult to identify infants who may have disease that is accompanied by subtle signs of gastroesophageal reflux, differentiation is essential to avoid placing healthy infants to costly research methods and may involve physical aggression and invasion. Medical treatment of gastroesophageal reflux disease is based on: postural therapy, dietary management, pharmacologic treatment. Surgical treatment is based on: restore the intraabdominal segment of the esophagus, restoring the angle of His and create a valve mechanism at the esophagogastric junction. This study was conducted in the area of Children's Hospital Gastroenterology Francisco de Icaza Bustamante. Aims to determine the clinical correlation between physiological reflux and gastroesophageal reflux disease in children under one year of outpatient attending the Children's Hospital Francisco de Icaza Bustamante from 2008 to 2011. His methodology is descriptive - correlational non-experimental design, longitudinal, retrospective study. The results show that the same clinical symptoms are observed to reflux and 44% vomiting, heartburn and dysphagia and cough 35%, 21% obstructive apnea. 64% of the clinical manifestations in infants were presented physiologically by gastroesophageal reflux, 36% was due to gastroesophageal reflux disease.
Gastroesophageal reflux in children under one year is a manifestation of the physiological process of maturation of the upper gastrointestinal tract during the first months of life. If disease is considered an entity with multiple clinical manifestations in children which vary according to age and severity reaching life threatening. It is difficult to identify infants who may have disease that is accompanied by subtle signs of gastroesophageal reflux, differentiation is essential to avoid placing healthy infants to costly research methods and may involve physical aggression and invasion. Medical treatment of gastroesophageal reflux disease is based on: postural therapy, dietary management, pharmacologic treatment. Surgical treatment is based on: restore the intraabdominal segment of the esophagus, restoring the angle of His and create a valve mechanism at the esophagogastric junction. This study was conducted in the area of Children's Hospital Gastroenterology Francisco de Icaza Bustamante. Aims to determine the clinical correlation between physiological reflux and gastroesophageal reflux disease in children under one year of outpatient attending the Children's Hospital Francisco de Icaza Bustamante from 2008 to 2011. His methodology is descriptive - correlational non-experimental design, longitudinal, retrospective study. The results show that the same clinical symptoms are observed to reflux and 44% vomiting, heartburn and dysphagia and cough 35%, 21% obstructive apnea. 64% of the clinical manifestations in infants were presented physiologically by gastroesophageal reflux, 36% was due to gastroesophageal reflux disease.
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REFLUJO GASTROESOFÁGICO, PEDIATRÍA, DIAGNÓSTICO CLÍNICO, EPIDEMIOLOGÍA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTÓN GUAYAQUIL, ECUADOR