A Study on Efficacy of UGI Scopy in Cholelithiasis Patients before Laparoscopic Cholecystectomy

Objectives. Upper abdominal symptoms are common in both gallstone disease and inflammatory disorders of gastroduodenum. To differentiate the causes of upper gastrointestinal symptoms due to gallstone and gastroduodenal disorders, upper gastrointestinal (UGI) scopy is a useful diagnostic tool. Our aim of study is to determine the efficacy of the preoperative UGI scopy and concurrent treatment of associated esophageal and gastric pathologies with symptomatic cholelithiasis in view of postoperative symptom reduction. Materials and Methods. This is a prospective study comprising 400 symptomatic cholelithiasis patients admitted in our institution. All patients underwent upper GI endoscopy (1–4 days) prior to cholecystectomy, and the findings were noted. Then, based on findings in UGI scopy, patients were grouped as group A (endoscopy normal) and group B (endoscopy with some findings). Group B patients were treated with medication, and both groups were operated with laparoscopic cholecystectomy. Pain and other symptoms in the preoperative period and postoperative period were measured and compared in both groups. Results. After excluding 7 patients with significant endoscopy findings, we have included 400 patients who underwent laparoscopy cholecystectomy. In a total of 400 patients, median age of presentation was 47.3 and female to male ratio was 2.2 : 1. Endoscopy showed some pathological findings in 75.5% patients, and the commonest endoscopy finding was gastritis. On comparison of pain score in preoperative patients, pain score was high in group B patients ( p < 0.05 ). Pain reduction was significant in postoperative 1st, 4th, and 6th weeks in both groups ( p < 0.0005 ). In the same way, other symptoms other than pain were compared which shows postoperative symptom reduction is highly significant in group B patients. Conclusion. Clinical presentation of cholelithiasis and other upper GI diseases resemble each other. It is difficult to discriminate between upper GI symptoms due to cholelithiasis or any other upper GI conditions. Although UGI scopy is not recommended for all patients with cholelithiasis, it may be beneficial to do UGI scopy in certain cholelithiasis patients with atypical presentation to prevent atypical symptoms after surgery.

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Clinical and endoscopic spectrum of upper gastrointestinal manifestations in HIV patients

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i1.3217 ◽

1970 ◽

Vol 8 (1) ◽

pp. 25-28 ◽

Cited By ~ 1

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

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

Gut ◽

10.1136/gut.41.3.297 ◽

1997 ◽

Vol 41 (3) ◽

pp. 297-302 ◽

Cited By ~ 51

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.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20180840 ◽

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.

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

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i12.1558 ◽

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

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Upper Gastrointestinal Symptoms in General Population of a District in Bangladesh

Journal of Enam Medical College ◽

10.3329/jemc.v4i2.19458 ◽

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. Students 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

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Gastric adenomyoma: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20181154 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1587

Author(s):

Sushma Bhardwaj ◽

Shourabh Sinha ◽

Reetu Kundu ◽

Ravinder Kaur

Keyword(s):

Peptic Ulcer ◽

Case Report ◽

Peptic Ulcer Disease ◽

Esophageal Varices ◽

Gastric Tumor ◽

Gi Bleeding ◽

Ulcer Disease ◽

Upper Gi ◽

Abdominal Symptoms ◽

Upper Gastrointestinal

Upper gastrointestinal (GI) bleeding is usually seen secondary to esophageal varices or peptic ulcer disease, but at times, unusual causes can be encountered. We present one such case of a young 30-year-old gentleman who presented with recurrent episodes of upper GI bleeding secondary to gastric adenomyoma (GA), a rare, benign gastric tumor that usually remains asymptomatic or presents with vague abdominal symptoms.

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

Journal of Investigative Medicine ◽

10.1136/jim-2020-001642 ◽

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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Role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.159238 ◽

2015 ◽

Vol 06 (02) ◽

pp. 059-065 ◽

Cited By ~ 1

Author(s):

Sharanabasavaraj Javali ◽

M. Madan ◽

M. L. Harendrakumar ◽

M. S. Mahesh

Keyword(s):

Rural Population ◽

Research Centre ◽

Common Symptom ◽

Age Group ◽

Gi Endoscopy ◽

Upper Gi ◽

Gastrointestinal Lesions ◽

Gi Symptoms ◽

Upper Gi Endoscopy ◽

Upper Gastrointestinal

Abstract Background and Objectives: Before the advent of endoscopy direct access to the lesion for the confirmation of the diagnosis was difficult, this posed difficulty in contemplating adequate and appropriate surgery. Endoscopy as a diagnostic and therapeutic tool has grown in recent years. Upper gastrointestinal (GI) endoscopy is one of the most fascinating branch which serves not only as a means of resolving or amplifying the diagnosis made clinically or by X-ray, but also a primary diagnostic procedure for conditions not otherwise diagnosable on unoperated case. Fiber optic upper GI endoscopy has already become firmly established as a reliable, quick and inexpensive tool. This study was done to detect the upper gastrointestinal lesions in rural population of Kolar District, the distribution pattern of various upper GI lesions in patients presenting with upper GI symptoms and to follow the endoscopic diagnosis for medical and surgical management. Materials and Methods: The study group includes patients reporting to outpatient department and also the inpatients in wards of General Surgery and other departments, who have upper GI symptoms, were advised endoscopy at R. L. JALAPPA Hospital and Research Centre, Kolar, from a period of December 2011 to August 2013. Results: Of the 600 cases, 370 were males, and 230 were females. Disease incidence was highest in 51–70 years age group, that is, 21.6%. Pain abdomen was the most common symptom. Epigastric tenderness was the most common sign among the patients clinically. Reflux esophagitis and diffuse gastritis formed most common cases (307 cases). The incidence of duodenitis - 7.83%, peptic ulcer -3.3%, esophageal varices - 1.5%, the incidence of carcinoma esophagus and carcinoma stomach was approximately same that is, 4.5% and 4.6% respectively. The incidence of esophageal candidiasis was 4.16%. The majority of the patients had a normal study that is, 14.5%. Conclusion: Upper GI lesions were more common in males. The incidence of diseases was highest among the elderly age group. Most of the benign mucosal lesions were mainly due to spicy food and habit of tobacco consumption. The incidence of malignancy was mostly among older age group above 50 years. The incidence of the normal study was high owing to increased medical care, easy availability of the procedure and increased medical awareness among patients. In all these cases, upper GI endoscopy not only helped in diagnosing the disease but also helped to get information about pathology, extent of disease and complications that have occurred. This study highlights the importance of diagnostic and therapeutic uses, recording of the various gastroenterological diseases we come across in rural population.

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The study of clinical and endoscopic spectrum of upper gastrointestinal manifestations in HIV patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181429 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1588

Author(s):

Raman Parashar ◽

Deepali Kaushik ◽

Praveen K. Malik

Keyword(s):

Early Diagnosis ◽

Opportunistic Infections ◽

Gastrointestinal Symptoms ◽

Common Finding ◽

Hiv Patients ◽

Upper Gi ◽

Antral Gastritis ◽

Gi Symptoms ◽

Candida Esophagitis ◽

Upper Gastrointestinal

Background: Opportunistic disorders are the most frequent GI complications of HIV infection and remain a major cause of morbidity and mortality in these patients. These disorders account for high prevalence of upper gastrointestinal symptoms such as dysphagia, odynophagia, retrosternal chest pain, abdominal pain and upper GI bleeding. Hence an attempt is being made to study clinical, endoscopic and biopsy changes in HIV patients with upper GI symptoms which helps us to make early diagnosis of upper GI disorders in HIV patients.Methods: HIV positive patients above 14 yrs diagnosed on the basis of recent NACO criteria having Upper G.I. symptoms, attending OPD of Department of Medicine admitted in Wards. All fifty three patients with upper G.I. symptoms were subjected to detail history, thorough clinical examination, routine and special investigations and Upper G.I Endoscopy.Results: Out of fifty three patients, nineteen (35.8%) cases had normal endoscopy. The most common finding was Antral Gastritis in fourteen (26.4%), followed by Candida esophagitis in twelve (22.6%), esophagitis in three (5.7%), candida esophagitis with antral gastritis in two (3.8%), duodenitis, varices and mass (ulcerated growth) in II part of Duodenum seen in one (1.9%) each.Conclusions: The evaluation of specific gastrointestinal complaints must be based on an assessment of degree of immunosuppression. With the progression of immunodeﬁciency, EGD becomes a useful diagnostic modality for the early diagnosis of these opportunistic infections and other inﬂammatory conditions.

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Study of upper gastrointestinal endoscopy in patients with gastrointestinal symptoms

International Surgery Journal ◽

10.18203/2349-2902.isj20194410 ◽

2019 ◽

Vol 6 (10) ◽

pp. 3595

Author(s):

Shashidhara Puttaraju ◽

Sudarshana Sreramaseshadri R. M.

Keyword(s):

Gastrointestinal Endoscopy ◽

Gastrointestinal Symptoms ◽

Significant Risk ◽

Upper Gastrointestinal Endoscopy ◽

Therapeutic Tool ◽

Gi Endoscopy ◽

Upper Gi ◽

Gi Symptoms ◽

Upper Gi Endoscopy ◽

Upper Gastrointestinal

Background: Upper gastrointestinal (GI) symptoms are the commonest complaints among the general population and the diseases associated with them carries a significant risk of morbidity and mortality. Hence early diagnosis and appropriate management of the condition can prevent life threatening complications. Upper GI endoscopy is an effective diagnostic as well as therapeutic tool for the patients presenting with upper GI symptoms. The objective of the study is to show the effectiveness of upper gastrointestinal endoscopy as an initial diagnostic, screening and therapeutic tool in patients with upper GI symptoms.Methods: Present study comprises of 100 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out-patients and referred patients) during the period of October 2018 to June 2019, who underwent upper GI endoscopy.Results: Out of 100 patients, 60 were males and 40 were females. In the study majority of the patients were found to have gastritis, esophagitis and acid peptic disease. Other patients had malignant changes, reflux disease, hiatus hernia, perforation, foreign body, obstruction and esophageal varices.Conclusions: Upper GI endoscopy is a simple, safe, more reliable and valuable tool with easy learning curve. It will remain as the initial investigation of choice for the patients with upper GI symptoms. It plays a significant role as a screening, diagnostic as well as therapeutic tool.

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