{"id":6001,"date":"2024-12-10T16:33:21","date_gmt":"2024-12-10T19:33:21","guid":{"rendered":"https:\/\/revistaabcd.org.br\/?p=6001"},"modified":"2025-02-10T16:38:04","modified_gmt":"2025-02-10T19:38:04","slug":"heterotopic-gastric-mucosa-of-the-esophagus-as-a-potential-cause-of-peptic-stenosis-after-roux-en-y-gastric-bypass","status":"publish","type":"post","link":"https:\/\/revistaabcd.org.br\/pt-br\/heterotopic-gastric-mucosa-of-the-esophagus-as-a-potential-cause-of-peptic-stenosis-after-roux-en-y-gastric-bypass\/","title":{"rendered":"HETEROTOPIC GASTRIC MUCOSA OF THE ESOPHAGUS AS A POTENTIAL CAUSE OF PEPTIC STENOSIS AFTER ROUX-EN-Y GASTRIC BYPASS"},"content":{"rendered":"<p>Heterotopic gastric mucosa of the proximal esophagus (HGMPE) is a congenital island of salmon-colored, abnormally located gastric epithelium, commonly present distally to the upper esophageal sphincter (UES). It can vary from microscopic and small foci to extensive and circumferential patches<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B11_ref\" data-ref=\"11\u00a0 11 von Rahden BH, Stein HJ, Becker K, Liebermann-Meffert D, Siewert JR. Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol. 2004;99(3):543-51. https:\/\/doi.org\/10.1111\/j.1572-0241.2004.04082.x\" rel=\"nofollow noopener\" target=\"_blank\">11<\/a><\/sup><\/span>.<\/p>\n<p>Most are largely asymptomatic<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B8_ref\" data-ref=\"8\u00a0 8 Lupu VV, Ignat A, Paduraru G, Mihaila D, Burlea M, Ciubara A. Heterotopic gastric mucosa in the distal part of esophagus in a teenager: case report. Medicine (Baltimore). 2015;94(42):e1722. https:\/\/doi.org\/10.1097\/MD.0000000000001722\" rel=\"nofollow noopener\" target=\"_blank\">8<\/a><\/sup><\/span>, found incidentally during esophagogastroduodenoscopies (EGD), with an underestimated prevalence ranging from 2.6 to 21%<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B1_ref\" data-ref=\"1\u00a0 1 Azar C, Jamali F, Tamim H, Abdul-Baki H, Soweid A. Prevalence of endoscopically identified heterotopic gastric mucosa in the proximal esophagus: endoscopist dependent? J Clin Gastroenterol. 2007;41(5):468-71. https:\/\/doi.org\/10.1097\/01.mcg.0000225519.59030.8d\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a><\/sup><\/span>,<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B9_ref\" data-ref=\"9\u00a0 9 Ohara M. Incidence of heteroptopic gastric mucosa in the upper esophagus in first time narrow banding image endoscopy of consecutive 900 patients. Gastrointest Endosc. 2010;71(5):PAB316-AB317. https:\/\/doi.org\/10.1016\/j.gie.2010.03.804\" rel=\"nofollow noopener\" target=\"_blank\">9<\/a><\/sup><\/span>.<\/p>\n<p>However, it can lead to complications such as bleeding, ulceration, neoplastic transformation, acid production, and laryngopharyngeal reflux, specifically chronic cough, throat discomfort, hoarseness, globus sensation, and regurgitation<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B3_ref\" data-ref=\"3\u00a0 3 Chong VH, Jalihal A. Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms. Eur Arch Otorhinolaryngol. 2010;267(11):1793-9. https:\/\/doi.org\/10.1007\/s00405-010-1259-2\" rel=\"nofollow noopener\" target=\"_blank\">3<\/a><\/sup><\/span>.<\/p>\n<p>Secretion can be acidic, as demonstrated by pH monitoring, and proton pump inhibitor may improve pharyngeal manifestations<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B7_ref\" data-ref=\"7\u00a0 7 Kim EA, Kang DH, Cho HS, Park DK, Kim YK, Park HC, et al. Acid secretion from a heterotopic gastric mucosa in the upper esophagus demonstrated by dual probe 24-hour ambulatory pH monitoring. Korean J Intern Med. 2001;16(1):14-7. https:\/\/doi.org\/10.3904\/kjim.2001.16.1.14\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a><\/sup><\/span>, but non-acidic mucus can also lead to symptoms<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B2_ref\" data-ref=\"2\u00a0 2 Bajbouj M, Becker V, Eckel F, Miehlke S, Pech O, Prinz C, et al. Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology. 2009;137(2):440-4. https:\/\/doi.org\/10.1053\/j.gastro.2009.04.053\" rel=\"nofollow noopener\" target=\"_blank\">2<\/a><\/sup><\/span>.<\/p>\n<p>The inlet patch is commonly a potential site for\u00a0<i>Helicobacter pylori<\/i>\u00a0infection. It is closely related to active inflammation and associated with\u00a0<i>H. pylori<\/i>\u00a0infection in the stomach<span class=\"ref\"><sup class=\"xref xrefblue\"><a href=\"https:\/\/www.scielo.br\/j\/abcd\/a\/p9qXHgKGJhsYcwR5nPymjDF\/?lang=en#B5_ref\" data-ref=\"5\u00a0 5 Gutierrez O, Akamatsu T, Cardona H, Graham DY, El-Zimaity HMT. Helicobacter pylori and hetertopic gastric mucosa in the upper esophagus (the inlet patch). Am J Gastroenterol. 2003;98(6):1266-70. https:\/\/doi.org\/10.1111\/j.1572-0241.2003.07488.x\" rel=\"nofollow noopener\" target=\"_blank\">5<\/a><\/sup><\/span>. The fact that HGMPE is commonly missed in EGDs can be explained, since it is located in the upper esophagus, a difficult area to examine due to the UES contraction, and is commonly neglected during device removal.<\/p>","protected":false},"excerpt":{"rendered":"<p>Heterotopic gastric mucosa of the proximal esophagus (HGMPE) is a congenital island of salmon-colored, abnormally located gastric epithelium, commonly present distally to the upper esophageal sphincter (UES). It can vary from microscopic and small foci to extensive and circumferential patches11. Most are largely asymptomatic8, found incidentally during esophagogastroduodenoscopies (EGD), with an underestimated prevalence ranging from [&hellip;]<\/p>","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"categories":[10],"tags":[],"class_list":["post-6001","post","type-post","status-publish","format-standard","hentry","category-letter-to-the-editor"],"acf":[],"modified_by":"Giovani","_links":{"self":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/6001"}],"collection":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/comments?post=6001"}],"version-history":[{"count":3,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/6001\/revisions"}],"predecessor-version":[{"id":6006,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/6001\/revisions\/6006"}],"wp:attachment":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/media?parent=6001"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/categories?post=6001"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/tags?post=6001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}