JAIME NATAN EISIG
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- Epidemiology of upper gastrointestinal symptoms in Brazil (EpiGastro): A population-based study according to sex and age group(2014) LATORRE, Maria do Rosario Dias de Oliveira; SILVA, Aline Medeiros da; CHINZON, Decio; EISIG, Jaime N.; DIAS-BASTOS, Telma R. P.AIM: To determine the prevalences of symptoms consistent with gastroesophageal reflux disease (GERD) and dyspepsia in South America. METHODS: A telephone survey was conducted among adult owners of land-based telephones in Sao Paulo, Brazil, using previously validated computer-assisted sampling and survey protocols. The Portuguese-language survey included (1) sociodemographic characteristics (e.g., weight, height, smoking) and comor-bidities; (2) dietary habits; (3) presence of symptoms consistent with GERD or dyspepsia within the prior 3 mo; and (4) use of medications and other therapies to manage symptoms. Data were stratified post-hoc into three homogeneous geographical regions of Sao Paulo according to the Social Exclusion Indices of the districts and postal codes. Survey response data from each respondent were weighted by the numbers of adults and landline telephones in each household. The analyses were weighted to account for sampling design and to be representative of the Sao Paulo population according to city census data. RESULTS: Among 4570 households contacted, an adult from 3050 (66.7%) agreed to participate. The nonresponse rate was 33.3%. The mean (SE) respondent age was 42.6 (16.0) years. More than half of all respondents were women (53.1%), aged 18 through 49 years (66.7%), married or cohabitating (52.5%), and/or above normal-weight standards (i.e., 35.3% overweight and 16.3% obese). A total of 26.5% of women were perimenopausal. More than 20% of respondents reported highly frequent symptoms consistent with GERD (e.g., gastric burning sensation = 20.8%) or dyspepsia (e.g., abdominal swelling/distension = 20.9%) at least once per month. Prevalences of these symptoms were significantly (approximately 1.5- to 2.0-fold) higher among women than men but did not vary significantly as a function of advancing age. For instance, 14.1% of women reported that they experienced stomach burning (symptom of GERD) at least twice per week, compared to 8.4% of men (P = 0.012 by x(2) test). A total of 15.7% of women reported that they experienced abdominal swelling (symptom of dyspepsia) at least twice per week, compared to 6.4% of men (P < 0.001 by x(2) test). Despite frequent manifestations of GERD or dyspepsia, most (>= 90%) respondents reported that they neither received prescription medications from physicians, nor took behavioral measures (e.g., dietary modifications), to manage symptoms. CONCLUSION: Symptoms consistent with dyspepsia and GERD are prevalent in Brazil and represent major public-health and clinical challenges.
bookPart Tumores do Estômago(2016) FERREIRA, Ricardo Paes Barreto; EISIG, Jaime Natan; MEDEIROS, Vitor de Souza; HASHIMOTO, Cláudio Lyoiti- Atualização em doença do refluxo gastroesofágico (DRGE): tratamento não farmacológico(2012) CARVALHAES, Aloisio; EISIG, Jaime Natan; RODRIGUEZ, Tomas Navarro; BERNARDO, Wanderley Marques
bookPart Ulcera gastroduodenal(2013) ZATERKA, Schlioma; EISIG, Jaime Natan- Influence of exercise testing in gastroesophageal reflux in patients with gastroesophageal reflux disease(2014) MENDES-FILHO, Antonio Moreira; MORAES-FILHO, Joaquim Prado Pinto; NASI, Ary; EISIG, Jaime Natan; RODRIGUES, Tomas Navarro; BARBUTTI, Ricardo Correa; CAMPOS, Josemberg Marins; CHINZON, DecioBackground : Gastroesophageal reflux disease is a worldwide prevalent condition that exhibits a large variety of signs and symptoms of esophageal or extra-esophageal nature and can be related to the esophagic adenocarcinoma. In the last few years, greater importance has been given to the influence of physical exercises on it. Some recent investigations, though showing conflicting results, point to an exacerbation of gastroesophageal reflux during physical exercises. Aim : To evaluate the influence of physical activities in patients presenting with erosive and non erosive disease by ergometric stress testing and influence of the lower esophageal sphincter tonus and body mass index during this situation. Methods : Twenty-nine patients with erosive disease (group I) and 10 patients with non-erosive disease (group II) were prospectively evaluated. All the patients were submitted to clinical evaluation, followed by upper digestive endoscopy, manometry and 24 h esophageal pH monitoring. An ergometric testing was performed 1 h before removing the esophageal pH probe. During the ergometric stress testing, the following variables were analyzed: test efficacy, maximum oxygen uptake, acid reflux duration, gastroesophageal reflux symptoms, influence of the lower esophageal sphincter tonus and influence of body mass index in the occurrence of gastroesophageal reflux during these physical stress. Results : Maximum oxigen consumption or VO 2 max, showed significant correlation when it was 70% or higher only in the erosive disease group, evaluating the patients with or without acid reflux during the ergometric testing (p=0,032). The other considered variables didn't show significant correlations between gastroesophageal reflux and physical activity (p>0,05). Conclusions : 1) Highly intensive physical activity can predispose the occurrence of gastroesophageal reflux episodes in gastroesophageal reflux disease patients with erosive disease; 2) light or short sessions of physical activity have no influence on reflux, regardless of body mass index; 3) the lower esophageal sphincter tonus does not influence the occurrence of reflux disease episodes during exercise testing.
- Probiotics intake and metabolic syndrome: A proposal (Retracted article. See vol. 39, pg. 85, 2014)(2011) BOGSAN, Cristina Stewart B.; FLORENCE, Ana Carolina R.; PERINA, Natalia; BARBUTI, Ricardo C.; NAVARRO-RODRIGUEZ, Tomas; EISIG, Jaime N.; OLIVEIRA, Marice N.Probiotics are practical tools to provide the modulation of microbiota. The ingestion of food or ingredients containing anti-inflammatory activity components as probiotics should be useful in obesity control and associated co-morbidities treatment. Metabolic syndrome is a metabolic dysfunction associated with visceral obesity and insulin resistance, in which the alterations in host microbiota interactions play an important role. Besides diet and physical activity, new strategies are necessary to control metabolic syndrome, and as consequence improving quality of life. This article revises the actual knowledge concerning probiotic intake and obesity as a proposal to control metabolic syndrome.
- Endoscopic findings in uninvestigated dyspepsia(2014) FAINTUCH, Jacob Jehuda; SILVA, Fernando Marcuz; NAVARRO-RODRIGUEZ, Tomas; BARBUTI, Ricardo Correa; HASHIMOTO, Claudio Lyoiti; ROSSINI, Alessandra Rita Asayama Lopes; DINIZ, Marcio Augusto; EISIG, Jaime NatanBackground: It is important to know the causes of dyspepsia to establish the therapeutic approach. Dyspepsia is a frequent syndrome in our country, where there are restrictions to endoscopy and high prevalence of Helicobacter pylori (H. pylori) infection. This study aimed to assess the endoscopic findings of the syndrome, in an outpatient screening clinic of a tertiary hospital in Sao Paulo. Methods: Outpatients with uninvestigated dyspepsia, according to Rome III criteria, answered a dyspepsia questionnaire and underwent esophagogastroduodenoscopy. The Rapid Urease Test was applied to fragments of the antral mucosa and epidemiological data were collected from the studied population. Organic dyspepsia findings were analyzed with different variables to verify statistically significant associations. Results: Three hundred and six patients were included and 282 were analyzed in the study. The mean age was 44 years and women comprised 65% of the sample. Forty-five percent of the patients reported alarm symptoms. Functional dyspepsia was found in 66% of the patients (20% with normal endoscopy results and 46% with gastritis), 18% had GERD and 13% had ulcers (duodenal in 9% and gastric in 4%). Four cases of gastric adenocarcinoma were identified (1.4%), one without alarm characteristics, 1 case of adenocarcinoma of the distal esophagus and 1 case of gastric lymphoma. The prevalence of H. pylori was 54% and infection, age and smoking status were associated with organic dyspepsia. The age of 48 years was indicative of alarm signs. Conclusions: The endoscopic diagnosis of uninvestigated dyspepsia in our setting showed a predominance of functional disease, whereas cancer was an uncommon finding, despite the high prevalence of H. pylori. Organic dyspepsia was associated with infection, age and smoking status.
- Low levels of adherence with proton pump inhibitor therapy contribute to therapeutic failure in gastroesophageal reflux disease(2012) DAL-PAZ, K.; MORAES-FILHO, J. P.; NAVARRO-RODRIGUEZ, T.; EISIG, J. N.; BARBUTI, R.; QUIGLEY, E. M. M.To assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross-sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne-GERD (162: 67.5%) or e-GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and patient awareness of their disease. 126 patients (52.5%) exhibited high level of adherence and 114 (47.5%) low level. Youngers (P= 0.002) or married (O.R. 2.41, P= 0.03 vs. widowers) patients had lower levels of adherence; symptomatic patients exhibited lower adherence (P= 0.02). All other variables studied had no influence on adherence. Patients with GERD attending a tertiary referral hospital in Sao Paulo exhibited a high rate of low adherence to the prescribed PPI therapy that may play a role in the therapy failure. Age <60 years, marital status and being symptomatic were risk factors for low adherence.
conferenceObject Diabetes and Dislipidemia Increase Significantly the Risk of Gastric Intestinal Metaplasia: A Prospective Study(2015) NAVARRO-RODRIGUEZ, Tomas; BARBUTI, Ricardo C.; EISIG, Jaime N.; DIB, Ricardo A.; ABRANTES, Eduardo F.; RIBEIRO, Karina B.; REIS, Luiz Fernando L.; MONTAGNINI, Andre L.conferenceObject Bifidobacterium Lactis B420/Streptococcus thermophilus TA040-Fermented Milk Improves Dyspepsia. A Prospective, Randomized, Double-Blind Trial(2014) BARBUTI, Ricardo C.; OLIVEIRA, Marice N.; PERINA, Natalia P.; HARO, Christiane; BOGSAN, Cristina S.; EISIG, Jaime N.; NAVARRO-RODRIGUEZ, Tomys