Actualización en la fisiopatología de la enfermedad por reflujo gastroesofágico
DOI:
https://doi.org/10.52787/agl.v52i2.212Palabras clave:
Enfermedad por reflujo gastroesofágica, unión gastroesofágica, esfínter esofágico inferior, mucosa esofágica, percepción sintomáticaResumen
La fisiopatología de la enfermedad por reflujo gastroesofágico es multifactorial. Los eventos involucrados se inician en el estómago y, en forma ascendente, afectan la unión gastroesofágica y el esófago. Las características del material refluido impactarán en la magnitud del daño mucoso y en la percepción sintomática. Existen mecanismos defensivos y factores agresores, que son determinantes de la enfermedad. La intensidad con la que se perciben los síntomas es variable en cada individuo y está determinada por una combinación de mecanismos modulados por el sistema nervioso central y periférico, y factores psicológicos como la hipervigilancia. Las alteraciones en el aclaramiento esofágico junto con el tipo de material refluido probablemente sean los mayores determinantes para el desarrollo de una enfermedad de tipo erosiva, mientras que la sensibilidad de la mucosa lo sea para la percepción sintomática. El desarrollo de la enfermedad por reflujo gastroesofágico es el producto de un desbalance entre los factores mencionados anteriormente. Entender cuál es el mecanismo fisiopatológico predominante permite ofrecer al paciente el mejor tratamiento disponible.
Citas
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