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.

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.

2013 ◽  
Vol 3 (2) ◽  
pp. 35-38
Author(s):  
MC Anup Kumar ◽  
Lavanya Karanam

ABSTRACT Objective The need for upper gastrointestinal (GI) endoscopy in the evaluation of hoarseness. Study design Prospective study, conducted during the period from June 2012 to February 2013. Setting Tertiary referral center. Results A total of 125 patients were selected for the study and they were evaluated with appropriate history and clinical examination. Out of 125 patients, 41 (32.8%) patients showed laryngeal findings leading to hoarseness, 13 (10.4%) patients showed features of suspected malignancy in other adjacent regions which was confirmed later, two (1.6%) patients showed phonetic gap and 69 (55.2%) patients showed normal laryngeal inlet on indirect laryngoscopy examination. Of the 69 normal patients which were treated conservatively and since they did not show any response they were subjected to upper GI endoscopy. Out of 69 patients, 41 (60%) patients showed features of gastritis, 28 (40%) patients showed features of duodenitis. Conclusion It is estimated that more than 50% of patients presenting to the ENT OPD for hoarseness are because of GI problems. We strongly advise upper GI endoscopy for the symptomatic otorhinolaryngological patients with a normal laryngeal finding on indirect laryngoscopy for treating the condition accurately or near accurately. Adding to this upper GI endoscopy has the additional advantages of documentation and medicolegal aspect in the present day scenario. How to cite this article Santosh UP, Kumar MCA, Karanam L. Upper Gastrointestinal Endoscopy in ENT Practice: How Worth is It? Int J Phonosurg Laryngol 2013;3(2):35-38.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P < 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P < 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.


Author(s):  
Amir Shafa ◽  
Anahita Hirmanpour ◽  
Behzad Nazemroaya ◽  
Fateme Jafari ◽  
Arash Pourreza

Background: Endoscopy is a diagnostic and therapeutic method with a high risk of nausea and vomiting. Considering the lack of adequate studies on the prevention of postoperative nausea and vomiting after endoscopy in children, this study was conducted to compare the effects of ondansetron, dexamethasone and a combination of these drugs on the reduction of nausea and vomiting in children aged 1 to 12 years undergoing upper gastrointestinal endoscopy. Methods: In this double-blind, randomized clinical trial, 146 children aged 1 to 12 years, undergoing upper gastrointestinal endoscopy were randomly allocated to four groups of 36. Before endoscopy, the groups received 0.1 mg / kg of ondansetron, 0.2 mg / kg dexamethasone, a combination of the two drugs and placebo, respectively. Results: According to the results of our study, children who underwent upper GI endoscopy, administration of ondansetron plus dexamethasone was associated with a significantly lower frequency of nausea in all assessment time points. However, the difference between the groups was significant only on admission to recovery and the 15 minutes after admission to recovery (P<0.001). Conclusion: The results of our study indicated that in children undergoing endoscopy, the use of ondansetron plus dexamethasone is associated with reduction in the incidence of nausea and vomiting, and the use of the combination does not cause significant side effects compared to ondansetron, dexamethasone or placebo, separately.


2019 ◽  
Vol 11 (2) ◽  
pp. 25-29
Author(s):  
Azizun Nessa ◽  
Muhammad Rabiul Hossain ◽  
Md Habibur Rahman ◽  
SM Mizanur Rahman ◽  
Abdullah Al Mamun ◽  
...  

Introduction: Dyspepsia affects up to 40% of the general population and significantly reduces the quality of life. Dyspeptic symptoms may be associated with endoscopically negative conditions, such as functional dyspepsia, or with organic lesions like peptic ulcer and oesophagitis which are easily detected by endoscopy. On the other hand, such lesions may also be asymptomatic and there is not always a clear cause and effect relationship between endoscopic findings and symptoms. Objective: To determine the prevalence of significant endoscopic lesion and or ultrasonographic findings and their association with dyspeptic symptoms in Bangladeshi rural population. Materials and Methods: This prospective cross sectional study was carried out in Nov 2015 to Dec 2015 in a field mobile hospital of Bangladesh Army, established in Daudkandi, Comilla where total 1094 uninvestigated dyspeptic patients were invited to participate in this cross sectional study and 105 typical dyspeptic patients were finally recruited as per Rome III criteria. Participants underwent clinical assessment through a preformed structured questionnaire and non video upper gastrointestinal endoscopy (UGIE) and ultrasonogram (USG) of hepatobiliary system (HBS). Results: The mean age of 105 participants (male-29; female-76) studied was 36.51±7.26 years with female preponderance (72.38%). Predominant symptoms were epigastric pain (69.52%), flatulence (34.28%), heart burn (28.57%) and diffuse abdominal pain (22.85%). Regarding treatment 48(45.71%) patients took proton pump inhibitors (PPI), 24 patients (22.85%) took H2 receptor blocker and 13 patients (12.38%) were on antacids irregularly. Seventeen patients (16.15%) had no history of medications for dyspepsia. Most of the patients (76.19%) had symptoms of less than 5 years. Organic dyspepsia was found in 68(64.76%) and functional dyspepsia in 37(35.23%) participants. Percentage of functional dyspepsia in male was 24.13% and in female it was 39.47% and the difference was statistically significant (p<0.05). In the organic dyspepsia group, upper GI endoscopy revealed 07(6.66%) duodenal ulcer, 02(1.9%) gastric ulcer, 04(3.8%) prepyloric ulcer and other inflammatory lesions like prepyloric gastritis in 46(43.80%) patients, antral gastritis in 06(5.7%) patients, duodenitis in 08(7.61%) patients and erosive oesophagitis in 03 patients(2.86%). Further USG revealed cholelithiasis in 02(1.90%) and gall bladder (GB) polyp in 01(0.95%) participants which could be the reason for their dyspeptic symptoms. Thirty Seven (35.23%) participants had normal UGIE (and also normal USG of HBS) but they had significant dyspeptic symptoms. Conclusion: Most of the patients (64.76%) in this study had significant upper GI endoscopic findings and labeled as organic dyspepsia and combined use of upper GI endoscopy and USG of HBS provided better yield for aetiological diagnosis of dyspepsia if there is any. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 25-29


2020 ◽  
Vol 13 (11) ◽  
pp. e236369
Author(s):  
Amr Elmoheen ◽  
Mahmoud Haddad ◽  
Khalid Bashir ◽  
Waleed Awad Salem

Upper gastrointestinal (GI) endoscopies are performed for several reasons. The overuse of endoscopy has negative effects on the quality of healthcare and pressurises endoscopy services. It also results in the complications. These complications include pneumoperitoneum, pneumomediastinum and subcutaneous pneumomediastinum. However, it is worth noting that these complications rarely occur during endoscopy of the upper GI tract. These complications, when they occur, indicate perforation of the retroperitoneal space or peritoneal cavity. In this article, we discuss a case of pneumoperitoneum, pneumomediastinum and subcutaneous emphysema after upper GI endoscopy.


2015 ◽  
Vol 06 (02) ◽  
pp. 059-065 ◽  
Author(s):  
Sharanabasavaraj Javali ◽  
M. Madan ◽  
M. L. Harendrakumar ◽  
M. S. Mahesh

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.


2021 ◽  
Vol 8 (3) ◽  
pp. 935
Author(s):  
Shashidhara Puttaraju ◽  
Sanhitha Purushotham

Background: Hiatus hernia refers to condition in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum.Hiatal hernia is a frequent finding during upper gastrointestinal endoscopy. Type I hiatal hernia is the sliding hiatal hernia, which accounts for more than 95% of all hiatal hernias with the remaining 5% being paraesophageal hiatal hernias taken together. Surgical therapy is recommended for patients with severe and refractory GERD symptoms such as poor compliance to long-term medical therapy and young patients wishing to avoid lifetime medical treatment. The objective of this study was to identify the associated symptoms and to determine diagnostic accuracy of endoscopic evaluation in patients with hiatus hernia.Methods: Current retrospective study comprised of 250 patients who presented with complaints of upper gastrointestinal symptoms and underwent upper gastrointestinal endoscopy in JSS hospital, Chamarajnagar during the period of October 2018 to May 2020.Results: Out of 250 patients, 162 males (64.8%) and 88 females (35.2%) were part of the study, who presented with upper GI symptoms, 12 (4.8%) patients were diagnosed with hiatus hernia. Out of these 12 cases, 9 patients (75%) were found to be having sliding type of hiatus hernia and 3 patients (25%) having rolling type.Conclusions: Early diagnosis and timely management or surgical intervention reduces morbidity associated with hiatus hernia and acid reflux. Hence, all patients presenting with persistent upper gastrointestinal symptoms should undergo upper GI endoscopy managed accordingly.


2021 ◽  
Vol 8 (21) ◽  
pp. 1679-1684
Author(s):  
Anand Hanumaiah ◽  
Savita K. Sridhar

BACKGROUND Dyspepsia is a term used to describe a number of symptoms thought to originate from the upper gastrointestinal tract. It may be caused by a variety of conditions such as peptic ulcer disease, gastro-oesophageal reflux, or even malignancy. Sometimes, dyspepsia is deemed to be functional. Endoscopy helps in differentiating these upper gastro-intestinal (GI) conditions. The objectives of this study were to determine the gastrointestinal findings in patients presenting with dyspepsia in our centre and compare them with those of other studies. METHODS This is a retrospective study of 100 consecutive patients who had undergone upper GI endoscopy for symptoms of dyspepsia from endoscopy data base at Karwar Institute of Medical Sciences, Department of Surgery, from January 2018 to March 2020. RESULTS Out of the total 100 patients who underwent upper GI endoscopy in our institution, 60 were males and 40 were females; youngest was aged 18 years and the oldest was 80 years old. 87 patients had abnormal findings and among these, 29 patients had finding in oesophagus, 54 in the stomach and 04 in the duodenum. A total of 13 patients were reported to be normal. CONCLUSIONS Dyspepsia is much common in males than females. Gastritis is the most common finding on endoscopy followed by oesophagitis and duodenitis other than reflux disorders. Along with proper history and physical examination, endoscopy helps in identifying serious pathologies like malignancy at earlier stage thus reducing morbidity and mortality. Endoscopy is the ‘gold standard test’ for patients with upper gastrointestinal symptoms. KEYWORDS Dyspepsia, Upper GI Endoscopy, Gastritis


2015 ◽  
Vol 12 (2) ◽  
pp. 101-105
Author(s):  
RB Gurung ◽  
B Purbe ◽  
B Malla ◽  
A Dhungel ◽  
S Yogol ◽  
...  

Background Routine use of sedation in upper gastrointestinal endoscopy is uncommon in Nepal. There is no study on use of propofol sedation in routine endoscopy examination in Nepal. This study was conducted in order to assess the patient satisfaction and safety profile in patient undergoing routine upper GI endoscopic examination on outpatients.Objective To study safety profile and patient satisfaction of use of propofol in patients undergoing upper GI endoscopy.Method A prospective, observational study was conducted in the endoscopy unit of Dhulikhel hospital, Kathmandu University Hospital from July 2011 to 2012 July. Patients who were referred to upper GI endoscopy were offered to sedation under propofol. Informed consent was taken after explaining side effects, advantages and risk-benefit to the clients. The propofol was administered by the endoscopy nurse under guidance and supervision of the endoscopy performing physician.Data were collected and analyzed using SPSS version 16.0 with 0.05 level of significance.Result Total of 203 patients included in the study. Among 203 patients, 21. 2% were males and 78.8% were females; 83.7% were of less than of 60 years age and 16.3% above 60 years of age. The mean total dose of propofol required was 136.08 ± 48.82 mg. Total of 29.1 % of cases required O2 administration during the procedure time due to transient drop in O2 saturation. Total of 4.4% of cases required fluid administration due to transient fall in blood pressure. Total of 68.0% of cases were completely sedated; 28.6% had minor restless and 3.4% showed agitation during induction period of propofol sedation. Total of 99.5% of patients reported pleasant experience while 0.5% reported unpleasant. Among 203 respondents, 98.5% responded they would prefer to do the procedure under propofol sedation in the future; 1.5% responded they did not want sedations in the future.Conclusion Upper GI endoscopy can safely be performed under propofol sedation administered by registered trained nurse under the supervision of endoscopist.Kathmandu University Medical Journal Vol.12(2) 2014: 101-105


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nancy Abdel Fattah Ahmed ◽  
Hebat-Allah Moheb Amer ◽  
Dina Abdallah Ibrahim ◽  
Islam Abd El-Hamid El-Zayyadi

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.


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