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HELICOBACTER PYLORI, DOLOR TORACICO Y SISTEMA NERVIOSO AUTONOMO

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En este artículo, explicamos el papel de la infección por Helicobacter pylori y el sistema nervioso autónomo en la patogenia de los trastornos funcionales del tubo digestivo y el dolor torácico.
Autor:
Jacek Budzynski
Columnista Experto de SIIC

Institución:
Department of Gastroenterology, Vascular Diseases and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz

Artículos publicados por Jacek Budzynski
Recepción del artículo
28 de Marzo, 2006 		Aprobación
3 de Abril, 2006
Primera edición
29 de Junio, 2007 		Segunda edición, ampliada y corregida
7 de Junio, 2021

HELICOBACTER PYLORI, DOLOR TORACICO Y SISTEMA NERVIOSO AUTONOMO

Resumen
El papel de la infección por Helicobacter pylori en las enfermedades gástricas está bien documentado, pero se debate aún su importancia en la patogenia de las enfermedades esofágicas y algunos trastornos fuera del tubo digestivo. Este artículo intenta revisar cierta información nueva relativa a la influencia de Helicobacter pylori sobre la actividad del sistema nervioso autónomo (SNA) como mecanismo de acción indirecta sobre el tubo digestivo y el sistema circulatorio. El efecto de Helicobacter pylori sobre el SNA puede ser el resultado de un efecto neurotóxico directo, la activación de procesos inflamatorios en los nervios, una deficiencia de microelementos y la estimulación inducida por los síntomas originados en los sistemas digestivo y circulatorio. El desequilibrio del SNA en los pacientes que presentan una infección por Helicobacter pylori puede afectar la motilidad esofágica, el grado del reflujo del contenido gástrico en el esófago, la evacuación gástrica, la acidez del jugo gástrico y el flujo sanguíneo de la mucosa. Estos trastornos provocan dispepsia, pirosis y dolor torácico. Este último requiere especial atención, debido a un resultado fatal potencial cuando el diagnóstico es erróneo. Puede ser difícil determinar el origen del dolor torácico, el que además puede ser multifactorial. Se deben tener en cuenta los trastornos esofágicos y cardíacos, así como las interrelaciones entre estos órganos, que dependen de los factores de riesgo en común para las enfermedades, reflejos vagales, una disminución del umbral para el dolor y los efectos adversos de los fármacos utilizados en el tratamiento de la angina de pecho.

Palabras clave
helicobacter pylori, variabilidad de la frecuencia cardíaca, sistema nervioso autónomo, dolor torácico, tracto digestivo


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The Role of Helicobacter pylori Infection and Autonomic Nervous System in the Pathogenesis of Functional Digestive Tract Disorders and Chest Pain

Abstract
Helicobacter pylori infection role in stomach diseases is well documented, but its significance in the pathogenesis of esophageal diseases and extra-digestive tract disorders is still discussed. This paper is addressed to review some new information concerning H. pylori influence on autonomic nervous system (ANS) activity as a mechanism of indirect action on the digestive tract and circulation system. Effect of H. pylori on ANS may result from the direct neurotoxic effect, activation of inflammatory processes in nerves, microelements deficiency, as well as from stimulation induced by symptoms arising from digestive and circulatory systems. ANS imbalance in H. pylori infected patients may affect esophageal motility, quantity of gastric content refluxed into esophagus, gastric emptying, gastric juice acidity and mucosal blood flow. These disturbances evoke dyspepsia, heartburn and chest pain. The last needs a special attention, because of potential fatal outcome when misdiagnosed. Determination of chest pain source may be difficult, moreover it can be multifactorial. Both esophageal and cardiac disorders, as well as interrelationships between these organs, depending on common diseases risk factors, vagal reflexes, decreased pain threshold and adverse effects of drugs applied in angina pectoris therapy should be taken into consideration.

Key words
helicobacter pylori, heart rate variability, autonomic nervous system, chest pain, digestive tract


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Especialidades
Principal: Gastroenterología, Infectología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Medicina Interna, Neurología



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Enviar correspondencia a:
Jacek Budzynski, Department of Gastroenterology, Vascular Diseases and Internal Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Ujejskiego 75 Street, 85-168, Bydgoszcz, Polonia
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