scholarly journals Insights into the evaluation and management of dyspepsia: recent developments and new guidelines

2018 ◽  
Vol 11 ◽  
pp. 175628481880559 ◽  
Author(s):  
Christopher J. Black ◽  
Lesley A. Houghton ◽  
Alexander C. Ford
Keyword(s):  
Epigastric Pain ◽  
Eradication Therapy ◽  
Tricyclic Antidepressant ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Canadian Association ◽  
Gi Symptoms ◽  
Epigastric Pain Syndrome ◽  
Upper Gi Endoscopy ◽  
H Pylori

Dyspepsia is a very common gastrointestinal (GI) condition worldwide. We critically examine the recommendations of recently published guidelines for the management of dyspepsia, including those produced jointly by the American College of Gastroenterology and the Canadian Association of Gastroenterology, and those published by the UK National Institute for Health and Care Excellence. Dyspepsia is a symptom complex, characterized by a range of upper GI symptoms including epigastric pain or burning, early satiety, and post-prandial fullness. Although alarm features are used to help prioritize access to upper GI endoscopy, they are of limited utility in predicting endoscopic findings, and the majority of patients with dyspepsia will have no organic pathology identified at upper GI endoscopy. These patients are labelled as having functional dyspepsia (FD). The Rome IV criteria, which are used to define FD, further subclassify patients with FD as having either epigastric pain syndrome or post-prandial distress syndrome, depending on their predominant symptoms. Unfortunately, the Rome criteria perform poorly at identifying FD without the need for upper GI endoscopy. This has led to the investigation of alternative diagnostic approaches, including whether a capsaicin pill or combined serum biomarkers can accurately identify patients with FD. However, there is insufficient evidence to support either of these approaches at the present time. Patients with FD should be tested for H. pylori infection and be prescribed eradication therapy if they test positive. If they continue to have symptoms following this, then a trial of treatment with a proton pump inhibitor (PPI) should be given for up to 8 weeks. In cases where symptoms fail to adequately respond to PPI treatment, a tricyclic antidepressant may be of benefit, and should be continued for 6 to 12 months in patients who respond. Prokinetics demonstrate limited efficacy for treating FD, but could be considered if other strategies have failed. However, there are practical difficulties due to their limited availability in some countries and the risk of serious side effects. Patients with FD who fail to respond to drug treatments should be offered psychological therapy, where available. Overall, with the exception of recommendations relating to H. pylori testing and the prescription of PPIs, which are made on the basis of high-quality evidence, the evidence underpinning other elements of dyspepsia management is largely of low-quality. Consequently, there are still many aspects of the evaluation and management of dyspepsia that require further research.

scholarly journals Histopathological Spectrum of Upper Gastrointestinal Endoscopic Biopsies in a Tertiary care centre

2021 ◽  
Vol 8 (6) ◽  
pp. A158-163
Author(s):  
Anjana M.L ◽  
Kavitha Yevoor
Keyword(s):  
Tertiary Care ◽  
Common Symptom ◽  
Female Ratio ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Wide Range ◽  
Neoplastic Lesions ◽  
Upper Gi Endoscopy ◽  
H Pylori ◽  
Duodenal Biopsies

Background: Upper GI endoscopy is an established procedure for investigating a wide range of upper GI conditions especially inflammatory and malignant diseases of stomach and esophagus. A good correlation in diagnosis can be achieved by complementing endoscopic findings with histopathology of biopsy specimens. Methods: Both retrospective and prospective study of upper GI endoscopic biopsy was carried out at department of pathology, KIMS, Hubli during January 2016 to December 2018. Samples were received in 10% formalin; routine processing was followed with H & E staining. Special stain like Giemsa was done for detection of H. Pylori. 396 endoscopic mucosal biopsies were analyzed and evaluated. Result: Out of 396 cases, 250 cases were esophageal biopsies, 104 cases were gastric biopsies & 42 cases were duodenal biopsies. The male: female ratio was 1:9:1. The highest number of cases was seen between 61 to 70 years. Dyspepsia was the common symptom seen in 61.3%. The most common lesions encountered in the esophagus were carcinomas (67%) followed by esophagitis (16%). The commonly encountered gastric lesion was chronic gastritis in 54.8% with H. pylori gastritis being positive in 38.18%. Among the duodenal biopsies, non-neoplastic lesions were most common (59.5%) followed by neoplastic lesions (26%). Conclusion: Upper GI endoscopy is an effective and appropriate preliminary investigation to assess patients with dysphagia, dyspepsia, vomiting. Endoscopy without biopsy is incomplete and that the combination of methods offers a strong diagnostic tool for better patient care.

scholarly journals UPPER GI ENDOSCOPY

2014 ◽  
Vol 21 (03) ◽  
pp. 460-464
Author(s):  
Muhammad Zakria ◽  
Awais Shuja
Keyword(s):  
Epigastric Pain ◽  
University Hospital ◽  
Persistent Vomiting ◽  
Gi Endoscopy ◽  
Endoscopic Findings ◽  
Upper Gi ◽  
Endoscopy Unit ◽  
Unit Design ◽  
Upper Gi Endoscopy ◽  
Independent University

Objective: To document various endoscopic findings in patients undergoingupper GI endoscopy in our endoscopy unit. Design: Observational. Patients and methods: Thedata of 100 patients who underwent upper GI endoscopy in Endoscopy Unit of IndependentMedical College/ Independent University Hospital from April 2010 to December 2012 wasanalyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted.Results: Among 100 patients, 35% were referred due to persistent vomiting, 28% due toepigastric pain / discomfort, 18 % due to dyspepsia and 7% due to retrosternal burning and uppergastrointestinal bleeding. Common endoscopic diagnoses were gastritis (28%), duodenitis(14%), gastroesophageal reflux disease / esophagitis (6%), esophageal varices (5%) andesophageal growth (4%). Conclusions: The most common presenting complaint was persistentvomiting followed by epigastric pain / discomfort and the most common endoscopic finding wasgastritis.

scholarly journals Prevalence of helicobacter pylori infection in patients with peptic ulcer disease at Kathmandu Model Hospital

2018 ◽  
Vol 8 (4) ◽  
pp. 3-7
Author(s):  
Rajesh Dhoj Joshi ◽  
Sachin Khadka ◽  
Deepak Man Joshi ◽  
Arun Kadel ◽  
Ganesh Dangal ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Rapid Urease Test ◽  
Gi Endoscopy ◽  
Ulcer Disease ◽  
Upper Gi ◽  
Urease Test ◽  
Upper Gi Endoscopy ◽  
H Pylori

Introduction: Endoscopic rapid urease test is a simple and most widely used test to detect the presence of urease in the gastric mucosa. Many studies have reported prevalence of H. pylori infection in relation to age, gender and site of ulcer. Therefore, this study was designed to determine the prevalence and significance of H. pylori in peptic ulcer disease. Methods: A retrospective review was carried out for patients with peptic ulcer disease who had undergone upper GI endoscopy in Department of Internal Medicine at Kathmandu Model Hos­pital. The records from January 2013 to December 2017 were analyzed. Any patient with previously diagnosed peptic ulcer, history of active bleeding, cancer and incomplete records were excluded. Peptic ulcer associated with H. pylori was diagnosed on the basis of endoscopic rapid urease test. Results: Among the 418 diagnosed case of peptic ulcer disease by upper GI endoscopy from Jan 2013 to Dec 2017, 213 tested positive for H. pylori by rapid urease test. Among the positive cases, over a half were males patients. Majority (23.9%) of the patients were in the age group of 35-44 years. Prevalence of H. pylori in duodenal ulcer was 51.6% followed by combined gastro-duodenal ulcer (26.8%) and gastric ulcer (21.6%). H. pylori was significantly associated with duodenal ulcer (p<0.0001). Conclusion: This study demonstrated relatively high prevalence of H. pylori infection in patients with duodenal ulcer who had undergone upper GI endoscopy.

scholarly journals Study on Gastrointestinal Evaluation of Iron Deficiency Anaemia Patients Attending at BIRDEM Hospital

2016 ◽  
Vol 33 (3) ◽  
pp. 126-132 ◽  
Author(s):  
Mohammad Shah Jamal ◽  
Md Anisur Rahman ◽  
Tareq M Bhuiyan ◽  
MG Azam ◽  
Shawhely Mahbub ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anemia ◽  
Stool Examination ◽  
Deficiency Anaemia ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Gi Endoscopy ◽  
Vascular Ectasias

Background: Anaemia is common among general population in developing Asian countries. Iron deficiency anaemia (IDA) is the commonest type of anaemia. It is usually due to chronic gastrointestinal blood loss. The standard of care for these patients with IDA includes evaluation of the Gastrointestinal (GI) tract for bleeding lesions. Iron deficiency anemia is considered as an alarm sign for the presence of possible GI malignancies, and inadequate evaluation of patients with IDA may delay the diagnosis of GI tumors especially colorectal cancer.Objective: To identify the gastrointestinal lesions endoscopically in patients with iron deficiency anaemia. To determine the usefulness of endoscopic procedures (both upper and lower GI) in diagnosis of underlying cause of iron deficiency.Method: This cross-sectional study was conducted to evaluate Iron deficiency anaemia in patients with or without GI symptoms during the period of July 2010 to December 2010 in the department of Gastroenterology, BIRDEM General Hospital. Sixty eight adult eligible patients with iron deficiency anaemia were taken as per inclusion criteria. All study subjects were underwent endoscopy and colonoscopic procedure after adequate preparation along with examination of their stool. Data were collected through faceto- face interview, observation and document review. Data were recorded and analyzed.Results: Majority of patients were 55 to 64 years age group (33.8%). Mean age ± SD of this study subject was 54.00 ±11.792 with maximum and minimum age 86 and 27 years respectively. More than half of the patients were female (51.5%) and rests were male 33 (48.5%). Among the study subjects, 70.58% patients had GI symptoms, 29.42% had non-GI symptoms. On stool examination, 17.64% patients had ova/cyst of helminthes; 82.36% were normal. Stool OBT revealed 11.8% positive and 88.2% negative. On upper GI endoscopy 32.4% had normal findings, 67.6% had some lesions. Majority of these lesions were ulcers and erosions (30.9%), malignancy (ca stomach) was 4.41%; others (which includes congestive gastropathy, reflux oesophagitis, vascular ectasias and helminthiasis) were 32.4%. On colonoscopy, 30.88% patients had normal colon; 69.12% had lesions. Among the lesions, most common lesion was hemorrhoids (36.76%); ca colon was 5.88% and others (includes ulcers, polyps, vascular ectasias and helminthes) were 26.47%. Patients with normal upper GI endoscopy- 50% had GI symptoms and 50% had non-GI symptoms whereas patients having lesions on upper GI endoscopy 80.4% had GI symptoms and 19.6% had non-GI symptoms. This difference was statistically significant (p<0.05). Patients with normal colonoscopy- 42.9% had GI symptoms and 57.1% had non-GI symptoms. On the other hand, patients having lesions on colonoscopy 70.6% had GI symptoms and 29.4% had non-GI symptoms. This was also statistically significant.Conclusion: Majority of the study population had lesions on endoscopy (both upper GI endoscopy and colonoscopy) including malignant lesions. Study showed that lesions are more common in patients with GI symptoms than those without GI symptoms (non-GI symptoms). Therefore, Routine endoscopic (both upper and lower GI) procedures is valuable in evaluating patients with iron deficiency anaemia- for diagnostic as well as therapeutic purposes. Effective treatment of patients with IDA is predicated on the identification of a specific lesion.J Bangladesh Coll Phys Surg 2015; 33(3): 126-132

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

2015 ◽  
Vol 06 (02) ◽  
pp. 059-065 ◽  
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.

scholarly journals Migraine, dyspepsia, and Helicobacter pylori; zeroing in on the culprit

2019 ◽  
Author(s):  
Nayereh Akbari ◽  
Ahmad Hormati ◽  
Ehsan Sharifipour ◽  
Seyed Amir Hejazi ◽  
Fatemeh Jafari ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcers ◽  
Significant Relation ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Urease Test ◽  
Upper Gi Endoscopy ◽  
H Pylori ◽  
The Impact

Background: Numerous studies have evaluated the impact of Helicobacter pylori (H. pylori) eradication on the number, severity, and recurrence of migraine attacks. But the association of migraine, H. pylori, and gastrointestinal (GI) presentation is challenging. The aim of the current study was to investigate the correlation between migraine, H. pylori, and peptic ulcers among patients with dyspepsia undergoing upper GI endoscopy. Methods: 305 patients with dyspepsia referring to our endoscopy ward, Shahid Beheshti Hospital affiliated to Qom University of Medical Sciences, Qom, Iran, for upper GI endoscopy filled out the study questionnaire. If a patient was experiencing headaches and the migraine was confirmed by neurologists, he/she was asked to answer the questions related to migraine, which were prepared exactly from Migraine Disability Assessment (MIDAS) questionnaire. The relation between migraine and confirmed H. pylori contamination was investigated using statistical models. Results: Of all the 305 patients, 133 (43.6%) had confirmed episodic migraine headaches (MHs) and 177 patients (58.04%) had positive RUT for confirming H. pylori contamination, of which 123 (69.5%) had confirmed migraine. 52 (17.0%) had duodenal peptic ulcer(s), of which, 49 (94.2%) had a positive rapid urease test (RUT) (P < 0.001). 20 (6.5%) of all patients had the gastric peptic ulcer(s) which did not have a significant relation with H. pylori contamination. There was a significant relationship between the peptic ulcer site and migraine. In total, 177 patients (58.0%) had a positive RUT. History of migraine was significantly positive in those with positive H. Pylori contamination. Notably, multivariable analysis demonstrated a significant relation of H. pylori and migraine at younger ages. Conclusion: The prevalence of H. pylori and migraine in patients with dyspepsia seems to be high. Moreover, there is a meaningful association between migraine, duodenal peptic ulcers, and H. pylori infection, too.  

scholarly journals Study of upper gastrointestinal endoscopy in patients with gastrointestinal symptoms

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.

Prevalence of H. pylori in an Inner-city Hospital on Upper GI Endoscopy

2015 ◽  
Vol 110 ◽  
pp. S1036
Author(s):  
Devika Kapuria ◽  
Raj Shah ◽  
Shariq Shamim ◽  
Khalil M. Abuamr ◽  
Nabil Al-Khalisi ◽  
...  
Keyword(s):  
Inner City ◽  
City Hospital ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
H Pylori

scholarly journals Prevalence of esophageal eosinophilia in patients referred for diagnostic upper gastrointestinal endoscopy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nancy Abdel Fattah Ahmed ◽  
Hebat-Allah Moheb Amer ◽  
Dina Abdallah Ibrahim ◽  
Islam Abd El-Hamid El-Zayyadi
Keyword(s):  
Eosinophilic Esophagitis ◽  
Reflux Esophagitis ◽  
Low Grade ◽  
Gi Endoscopy ◽  
Presenting Symptoms ◽  
Upper Gi ◽  
Esophageal Eosinophilia ◽  
Gi Symptoms ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background Several conditions are associated with esophageal eosinophilia such as eosinophilic esophagitis (EoE) and gastro-esophageal reflux disease (GERD). The aim of this study was to detect the prevalence of esophageal eosinophilia in patients with upper gastrointestinal (GI) symptoms referred for diagnostic upper GI endoscopy. This study included 86 patients who underwent upper GI endoscopy and biopsies. Results Esophageal eosinophilia EE was found in 26 patients (30.2%): 3 patients (3.5%) had EoE and 23 patients (26.7%) had low-grade esophageal eosinophilia. The most common presenting symptoms were heart burn in 84 patients (97.7%) and upper abdominal pain in 78 patients (90.7%). Reflux esophagitis (ERD) was observed in 18.6% of patients. In histopathological examination, EoE was found in 3.5%, mild reflux esophagitis in 37.2%, and severe reflux esophagitis in 16.3%. There is statistically significant correlation between EE and male sex, hypertension, dysphagia, hiatus hernia, incompetent cardia, and fixed rings. Age, incompetent cardia, and dysphagia were statistically significant independent predictors of low-grade EE. Conclusion Esophageal eosinophilia EE was found in 30.2% of patients: 3.5% had eosinophilic esophagitis EoE and 26.7% had low-grade esophageal eosinophilia.

USE OF ROADMAP FLUOROSCOPY IN UPPER GI ENDOSCOPY

2020 ◽  
Author(s):  
J Weigt ◽  
W Elhossary ◽  
W Obst ◽  
P Maciej
Keyword(s):  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy
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