Reflujo gastroesofagico
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ERGE
DR. GARCIA V R4CG
HGR # 1 OBREGON SONORA
IMSS
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REFLUJO
● PASO DEL CONTENIDO GASTRICO AL
ESOFAGO
– 40% de la poblacion presenta reflujo una vez al mes
– Más de 20 millones presetan diario.
– Prevalencia de 5-7 %
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ERGE
● SINTOMAS OCASIONADOS POR EL REFLUJO
CONSTANTE AL ESOFAGO Y QUE YA
OCASIONAN DAÑO AL MISMO.
● Transtorno digestivo comun caracterizado por
pirosis y regurgitacion ácida con o sin daño de la
mucosa esofagica.
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●PATOLOGIA MAS FRECUENTE DE
ESOFAGO
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ESFINTER ESOFAGICO INF
● BARRERA CONTRA EL REFLUJO
– RESION DE 12 A 30 MMHG
– 3 A 5 CM
– - 6MM HG Y – 2CM ------ RGE
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● SE RELACIONA CON HERNIA HIATAL
● NO ES DIAGNOSTICO
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CAUSAS RGE
● TONO DEFICIENTE DE LAS FIBRAS
MUSCUARES
● ALTERACION EN LOS MOV ESOFAGICOS
● VACIAMIENTO GASTRICO DEFICIENTE
● HERNIA HIATAL
● TABAQUISMO
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● OBESIDAD
● ABUSO DE ALCOHOL
● ENFERMEDADES DEL COLAGENO
● MEDICAMENTOS
● ALIMENTOS GRASOS O CONDIMENTADOS
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● SINTOMAS
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SINTOMAS
● PIROSIS
– DOLOR EPIGASTRICO
– PUNZANTE
– NO IRRADIADO
– NO OPRESIVO
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● REFLUJO
– ALIMENTOS DIGERIDOS
– ALIMENTOS NO DIGERIDOS
– DISFAGIA
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SINTOMAS EXTRAESOFAGICOS
● TOS CRONICA
● DISFONIA
● CARIES
● PNEUMONIAS
● SINOMAS DE ASMA
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DIAGNOSTICO
● ENDOSCOPIA
● MANOMETRIA
● PH METRIA
● ESOFAGOGRAMA
● GAMAGRAFIA
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C. SAVARY-MILLER
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● TRATAMIENTO
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Tratamiento
● MODIFICACIONES ESTILO DE VIDA
● TRATAMIENTO MEDICO
● TRATAMENTO QUIRURGICO
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Modificaciones estilo de Vida
● Cabecera elevada 30 grados
● No ropa ajustada
● No acostarse antes de 2 hrs post a cena
● Procurar alimentos solidos
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Evitar
● Chocolate
● Menta
● Citricos
● Refrescos
● Salsas
● Grasas
● Alimentos calientes o muy frios
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Tratamieto Medico
● Antiacidos
● Bloqueadores H2
● Antagonistas bomba de protones
● Procineticos
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Indicaciones Qx
● Duracion prolongada de los sintomas
● Jovenes sintomaticos
● Recaidas pese a tratamiento medico
● indicios de lesiones graves en esofago
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