scholarly journals Contribution of acid and duodenogastrooesophageal reflux to oesophageal mucosal injury and symptoms in partial gastrectomy patients

Gut ◽  
1997 ◽  
Vol 41 (3) ◽  
pp. 297-302 ◽  
Author(s):  
M F Vaezi ◽  
J E Richter
Keyword(s):  
Patient Group ◽  
Partial Gastrectomy ◽  
Mucosal Injury ◽  
Acid Reflux ◽  
Glass Electrode ◽  
Oesophageal Reflux ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Gastrointestinal

Background—The role of acid and pepsin in causing symptoms and oesophagitis is well established; however, the significance of duodenogastro-oesophageal reflux (DGOR) in this disorder is unclear.Aims—To understand the role of acid and DGOR in causing upper gastrointestinal (GI) symptoms and oesophageal mucosal injury in partial gastrectomy (PG) patients.Methods—Thirty two PG patients with upper GI symptoms were studied. Twenty four hour ambulatory acid and bilirubin measurements were obtained with Bilitec 2000 using glass electrode and fibreoptic sensor. Upper GI symptoms and oesophagitis were correlated with either acid or DGOR.Results—The PG patients were a heterogeneous group: 28% (9/32) had mixed reflux (acid+/DGOR+); 50% (16/32) had only DGOR (acid−/DGOR+); and 22% (7/32) had neither (acid−/DGOR−). Upper GI symptoms were associated with both mixed reflux (69%) and DGOR (24%). Six patients (67%) in the acid+/DGOR+ group had oesophagitis; no acid−/DGOR+ or acid−/DGOR− patients had oesophagitis. Mixed reflux showed a significant (p<0.0001) association with oesophagitis, while DGOR did not (p=0.3).Conclusions—(1) The majority of upper GI symptoms and all cases of oesophagitis in the PG patients occurred in patients who had mixed refluxate (acid and DGOR); (2) DGOR without simultaneous acid reflux may cause symptoms, but was not associated with oesophagitis in this patient group.

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

scholarly journals Clinical and endoscopic spectrum of upper gastrointestinal manifestations in HIV patients

1970 ◽  
Vol 8 (1) ◽  
pp. 25-28 ◽  
Author(s):  
VN Ravikumar ◽  
K Rudresh ◽  
U Jalihal ◽  
R Satish ◽  
R Manjunath
Keyword(s):  
Weight Loss ◽  
Epigastric Pain ◽  
Cd4 Count ◽  
Common Finding ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Mucosal Involvement ◽  
The Mean ◽  
Upper Gastrointestinal ◽  
Oesophageal Candidiasis

Background: Human Immunodeficiency Virus (HIV) infected patient frequently report upper gastrointestinal (GI) symptoms; however their prevalence and diagnostic approach is not well known. Objective: The objective of this study was to study clinical, endoscopic and histopathological changes in HIV infected patients with upper GI symptoms and their correlation with CD4 count. Materials and methods: We evaluated 50 HIV infected patients who presented to M.S. Ramaiah hospital with upper GI symptoms. All patients answered questionnaire assessing upper GI symptoms and underwent upper GI endoscopy. Mucosal biopsy was taken wherever mucosal abnormality seen. Results: In our study, the mean age of patients was 40.98 yrs, of which 80% were males. Vomiting (36%), epigastric pain (36 %), weight loss (34 %) and anorexia (34%) were the predominant symptoms. Esophagogastroduodenoscopy (EGD) findings revealed- Oesophageal candidiasis in 28.0%, esophagitis in 22.0%, gastritis in 20.0 %, duodenitis in 14 %, normal upper GI mucosa in 18 % patients. Oesophageal candidiasis was the most common finding on histopathological examination and the mean CD4 count was 157.92 cells/μl. Conclusion: Vomiting, epigastric pain, weight loss and anorexia were most frequent symptoms. Oral candidiasis was the most common oral lesion. Oesophageal candidiasis, oesophagitis and oesophageal ulcers were the common findings on EGD. Patient with CD4 count less than 200cells/μl had more frequent upper GI mucosal involvement than in patients with CD4 count more than 200. Majority of the patients with GI symptoms had upper GI mucosal changes and opportunistic infections. Thus endoscopic and histopathological evaluation is advisable for the early diagnosis and treatment of upper GI complications in patients with HIV infection. Key words: AIDS; Oesophageal candidiasis; Esophagogastroduodenoscopy; HIV; Upper gastrointestinal symptoms. DOI: 10.3126/kumj.v8i1.3217 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 25-28

DOZ047.04: Upper gastrointestinal microbiome in esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
U Krishnan ◽  
H Singh ◽  
N Kaakoush
Keyword(s):  
Esophageal Atresia ◽  
Eosinophil Count ◽  
Illumina Miseq ◽  
Acid Reflux ◽  
Gastric Fluid ◽  
Rrna Gene ◽  
Upper Gi ◽  
The Mean ◽  
Endoscopic Assessment ◽  
Upper Gastrointestinal

Abstract Background Esophageal atresia (EA) is a rare defect, resulting in the condition being understudied. Specifically, information on the upper gastrointestinal (GI) microbiome of EA patients is lacking. Aims This study aimed to examine the composition of the upper GI (oral, esophageal, and gastric fluid) microbiomes of EA patients as compared to controls. Methods A pediatric cohort was prospectively recruited at Sydney Children's Hospital in 2018, and comprised children with a history of EA and those without EA. The groups were subdivided into children with GERD, eosinophilic esophagitis (EoE), and those with no disease. Biopsies, saliva, blood, and both tracheal and gastric aspirates were collected. Histology was reviewed for changes related to reflux and peak eosinophil count in subjects with EoE. Ethics approval has been granted and informed consent obtained from all patients and/or their guardians. The bacterial component (16S rRNA gene) of the microbiome was amplified using the 515F–806R primers and sequenced with Illumina MiSeq 2 × 250 bp chemistry. Reads were analyzed using mothur and R. Results Within the cohort (n = 47), 29 (61.7%) had EA and 18 (39.3%) were non-EA patients. The mean age of the whole cohort was 8.36 years (SD 5.05) and 24 (44%) were male. Non-EA patients were having endoscopic assessment of GERD, EoE, suspected celiac or inflammatory bowel disease (IBD). Active GERD, defined as histological changes on biopsy, an abnormal acid reflux index, or retrograde bolus movement on pH/impedance testing, was present in 11 (23.4%; 5 with EA) children. The mean eosinophil count in patients with EoE was 11.1 (SD 14.74) in the EA cohort and 15.9 (SD 21) in the non-EA cohort. Proton pump inhibitors were used by 29 (61.7%; 16 with EA). EoE was present in 18 (44.4%; 8 with EA). Swallowed steroids were used in 13 (27.6%) patients with EoE. Microbiome changes were observed in patients with EA as compared to controls. Conclusions This study is the first to examine the upper GI microbiome of children with EA. Changes in the upper GI microbiomes of children with EA require validation in larger cohorts.

Enterogastric Reflux: An Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

scholarly journals A clinico-endoscopic study of upper GI disorders in rural population

2018 ◽  
Vol 5 (3) ◽  
pp. 1111
Author(s):  
Ramesh Ainapure ◽  
Vishal Tanga
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Symptoms ◽  
Upper Gastrointestinal Tract ◽  
Common Finding ◽  
Gastrointestinal Disorders ◽  
Oesophageal Varices ◽  
Early Management ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal disorders are commonly seen in routine clinical practice. The definitive diagnosis of upper gastrointestinal disorders rest on endoscopic evaluation and biopsy if required for planning proper treatment. The objectives of the study were to determine the spectrum of disease in upper gastrointestinal tract and to establish endoscopy as an effective tool in the proper diagnosis of various upper gastrointestinal tract disorders.Methods: A prospective study was conducted among patients who presented with upper gastrointestinal symptoms at Gadag Institute Medical College, from August 2016 to August 2017, Gadag. After history taking and physical examination, patients were subjected to fibre-optic upper GI scopy.Results: The result of present study showed male predominance associated with the upper GI disorders. Gastritis (45.65%) was the most common finding followed by normal exam (17.39%), GERD (6.83%), oesophageal cancer (2.17), Oesophagitis (4.34), gastric ulcer (9.31%), and gastric cancer (3.10%), duodenitis (5.90%) and oesophageal varices at 5.27% Gastritis is the most common upper GI disorder seen the patient population.Conclusions: Upper GI endoscopy is an effective and appropriate approach for initial investigation to assess patients with GI symptoms. Thus, it helps early management gastric disorders.

scholarly journals THE SYMPTOMS OF UPPER GASTROINTESTINAL, PSYCHOSOCIAL CO-MORBIDITY, EFFECTS ON PATIENTS & HEALTH CARE SEEKING IN GENERAL PRACTICE

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Khaled Hassan
Keyword(s):  
Health Care ◽  
General Practice ◽  
Care Utilization ◽  
Multivariable Logistic Regression Analysis ◽  
Odds Ratios ◽  
Upper Gi ◽  
Co Morbidity ◽  
Gi Symptoms ◽  
Gastrointestinal Problems ◽  
Upper Gastrointestinal

There is also a limited understanding of the pathophysiology of upper gastrointestinal (GI) effects. In patients with functional gastrointestinal problems, psychological symptoms have been shown to be more frequent, although it is disputed if they are directly related to GI symptoms or rather indicate reasons for seeking health treatment. The aim of our research was to compare co-morbidity between patients with and without upper GI symptoms, particularly psychological and social problems. Furthermore, we explored whether the occurrence of psychiatric and social disorders was part of a larger trend of health care utilization due to sickness. Case control research focused on the population based on the second Dutch National Survey of General Practice (conducted in 2001). Cases and controls (individuals not experiencing any of these complaints) matched by gender, age, PCP-practice and ethnicity were contrasted (adults attending their primary care provider (PCP) with upper GI symptoms). The key outcome indicators were communication duration, somatic and psychosocial diagnosis prevalence, (psycho) pharmacological agent dosage levels, and referral rates. Using odds ratios, the Chi square test and multivariable logistic regression analysis, the data was analyzed. As a result, data was analyzed for 13,389 patients with upper GI signs and 13,389 control patients. Twice as often as controls (8.6 vs 4.4 times/year), patients with upper GI symptoms attended their PCP. There were not only more psychiatric and emotional issues in people with upper GI signs, but also more clinical problems in their PCP (odds ratios (ORs) ranged from 1.37 to 3.45). Drugs of any ATC type (ORs range from 1.39 to 2.90), including psychotropic agents, have been used most commonly in patients with upper GI symptoms. When we corrected for non-attending control patients, the found variations were less pronounced. In the multivariate regression study, patients with upper GI effects were more closely correlated with communication frequency and not psychiatric or social co-morbidity. To conclude, people with upper GI symptoms most often attend their PCP for some organ system issues, even psychosocial problems. The correlation between upper GI symptoms and psychological issues is misleading and could represent higher health care standards in general. Keywords: gastrointestinal

Upper GI Bleed, Etiology, Role of Endoscopy in Rural Population of Punjab

2012 ◽  
pp. 208-221
Author(s):  
Ravinder Singh Malhotra ◽  
K. S. Ded ◽  
Arun Gupta ◽  
Darpan Bansal ◽  
Harneet Singh
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Cause ◽  
Endoscopic Techniques ◽  
Upper Gi ◽  
Gi Bleed ◽  
Upper Gastrointestinal ◽  
Common Variable

Haematemesis and malena are the two most important symptoms of upper gastrointestinal bleeding . The most common cause of upper gastrointestinal bleeding is due to a peptic ulcer. In this paper, the authors research the cause of bleeding. Contrary to previous studies, results favor esophageal varices, e.g., alcoholism or cirrhosis liver post necrotic, as the most common cause of bleeding rather than a peptic ulcer. The authors’ study is based on an observational retrospective protocol with records of 50 consecutive patients with GI bleeding, attending the emergency room from February 2007 until September 2009. Results show that the treatment of UGI bleeding has made important progress since the introduction of emergency endoscopy and endoscopic techniques for haemostasis. The application of specific protocols significantly decreases rebleeding and the need for surgery, whereas mortality is still high. The data highlight the decreasing trend of peptic ulcer as the sole cause of bleeding, as shown in previous literature, ascertaining that varices are now the most common variable.

scholarly journals Upper Gastrointestinal Symptoms in General Population of a District in Bangladesh

2014 ◽  
Vol 4 (2) ◽  
pp. 79-88
Author(s):  
Irin Perveen ◽  
Mufti Munsurar Rahman ◽  
Madhusudan Saha
Keyword(s):  
General Population ◽  
Gastrointestinal Symptoms ◽  
Duration Of Symptoms ◽  
Upper Gi ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
Number Frequency ◽  
Symptom Prevalence ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (GI) symptoms are common complaints affecting 25--40% of the general population and are common causes of health care utilisation and substantially affect the quality of life. In day-to-day practice our clinicians have to face good number of patients with various upper GI symptoms. But we have limited data on the prevalence of different upper GI symptoms in our community. Objective: The present study aimed to find out the prevalence of different upper GI symptoms in the general population of a district in Bangladesh. Materials and Methods: This population-based observational study was conducted in a selected district of Bangladesh. Three thousand subjects selected by cluster sampling method were interviewed by a valid bowel disease questionnaire. Student’s t test and chi-square tests were used for comparison of different variables with significance level set at 0.05. Results: Among the study population 1523 were men and 1477 were women with a mean age of 33.91 ± 16.43 years. A total of 2273 (75.8%) persons had at least one upper GI symptom, 2072 (69.1%) had 2 or more symptoms and 1705 (56.8%) had 3 or more symptoms in the prior 3 months. Nine hundred sixty three subjects (32.1%) had upper abdominal pain, 1265 (42.16%) had bloating, 1354 (45.13%) had heart-burn, 1166 (38.87%) had chest pain, 1347 (44.9%) had early satiation and 258 (8.6%) had vomiting. Around 249 (8.3%, male 123, female 126, P=0.691) was diagnosed as functional dyspepsia, 187 (6.2%, male 82, female 105, P=0.059) as gastroesophageal reflux disease (GERD) and 55 (1.83%, male 27, female 28, P=0.892) as upper abdominal bloating. Only one woman fulfilled the criteria for functional gallbladder or sphincter of Oddi dysfunction. Approximately 40.56% dyspeptic patients had overlapping GERD symptoms. Symptom prevalence was found to decrease with increased number, frequency and duration of symptoms. Conclusion: Upper GI symptoms are prevalent in our community. Multiple upper GI symptoms do exist simultaneously. Symptom prevalence varies with number, frequency and duration of symptoms. DOI: http://dx.doi.org/10.3329/jemc.v4i2.19458 J Enam Med Col 2014; 4(2): 79--88

scholarly journals Investigation of oral, gastric, and duodenal microbiota in patients with upper gastrointestinal symptoms

2020 ◽  
Vol 69 (4) ◽  
pp. 870-877
Author(s):  
Jorge Cervantes ◽  
Majd Michael ◽  
Bo-Young Hong ◽  
Aden Springer ◽  
Hua Guo ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Microbiota Composition ◽  
Gi Tract ◽  
Upper Gi ◽  
Functional Gi Disorders ◽  
Gi Symptoms ◽  
Dyspeptic Symptoms ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal ◽  
Gastric Microbiota

Disease-associated alterations of the intestinal microbiota composition, known as dysbiosis, have been well described in several functional gastrointestinal (GI) disorders. Several studies have described alterations in the gastric microbiota in functional dyspepsia, but very few have looked at the duodenum.Here, we explored the upper GI tract microbiota of inpatients with upper GI dyspeptic symptoms, and compared them to achalasia controls, as there is no indication for an esophagogastroduodenoscopy in healthy individuals.We found differences in the microbiota composition at the three sites evaluated (ie, saliva, stomach and duodenum). Changes observed in patients with dyspepsia included an increase in Veillonella in saliva, an oral shift in the composition of the gastric microbiota, and to some degree in the duodenum as well, where an important abundance of anaerobes was observed. Metabolic function prediction identified greater anaerobic metabolism in the stomach microbial community of patients with dyspepsia. Proton pump inhibitor use was not associated with any particular genus. Co-abundance analysis revealed Rothia as the main hub in the duodenum, a genus that significantly correlated with the relative abundance of Clostridium, Haemophilus, and Actinobacillus.We conclude that patients with upper GI symptoms consistent with dyspepsia have alterations in the microbiota of saliva, the stomach, and duodenum, which could contribute to symptoms of functional GI disorders.

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