scholarly journals Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI

2020 ◽  
Author(s):  
Bandar Saad Assakran ◽  
Khaled Mohammed Alrakbi ◽  
Meshari Abdulrahman Alharbi ◽  
Moath Abdullah Almatroudi ◽  
Asim Nizar Alshowaiman ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Microsoft Excel ◽  
Chi Square ◽  
Chi Square Test ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia. The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy assessment and correlation with BMI. Methods This was an observational retrospective cohort study conducted at King Fahad Specialist hospital - Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had preoperative upper gastrointestinal endoscopy assessment between January 2017 – December 2019. Data were tabulated in Microsoft Excel and were analyzed using SPSS version 21. Results Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.9%. Chi-square test revealed that the abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023), while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH. Conclusion Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was found to decrease the symptoms associated with HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.

scholarly journals Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI

2020 ◽  
Author(s):  
Bandar Saad Assakran ◽  
Khaled Mohammed Alrakbi ◽  
Meshari Abdulrahman Alharbi ◽  
Moath Abdullah Almatroudi ◽  
Asim Nizar Alshowaiman ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Protective Factor ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Chi Square ◽  
Chi Square Test ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia.Aim The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy screening and correlation with BMI.Materials and Methods This was an observational retrospective cohort study conducted at King Fahad Specialist hospital-Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had upper gastrointestinal endoscopy screening between January 2017 – December 2019. Data were tabulated in MS Excel and were analyzed using SPSS version 21.Results Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.3%. Chi-square test revealed that the use of Proton-pump inhibitors (PPI) (X2=6.876; p=0.009) and abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023) significantly decreased the risk of HH while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH.Conclusion Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was a protective factor of HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.

scholarly journals Study on incidence of hiatus hernia in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 935
Author(s):  
Shashidhara Puttaraju ◽  
Sanhitha Purushotham
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Gastrointestinal Endoscopy ◽  
Gastrointestinal Symptoms ◽  
Upper Gastrointestinal Endoscopy ◽  
Type I ◽  
Care Hospital ◽  
Upper Gi ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal

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.

A Comparative study between Dexmedetomidine versus Propofol for sedation in upper GI endoscopy procedure considering effect on intraoperative vital data, patient amnesia and onset of recovery after the procedure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Day Case ◽  
Upper Gi ◽  
Significant Difference ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

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.

scholarly journals Acute Gastric Volvulus on Hiatal Hernia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Abdessamad EL KAOUKABI ◽  
Mohamed MENFAA ◽  
Samir HASBI ◽  
Fouad SAKIT ◽  
Abdelkrim CHOHO
Keyword(s):  
Hiatal Hernia ◽  
Gastrointestinal Endoscopy ◽  
Epigastric Pain ◽  
Gastric Volvulus ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Entity ◽  
Midline Laparotomy ◽  
Acute Gastric Volvulus ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

scholarly journals Comparison of the Prophylactic Effect of Ondansetron, Dexamethasone, and the Combination of These Drugs on Decreasing Nausea and Vomiting in Children Aged 1 to 12 Years Old Undergoing Upper Gastrointestinal Endoscopy

2019 ◽  
Author(s):  
Amir Shafa ◽  
Anahita Hirmanpour ◽  
Behzad Nazemroaya ◽  
Fateme Jafari ◽  
Arash Pourreza
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Upper Gastrointestinal Endoscopy ◽  
Double Blind ◽  
Upper Gi ◽  
Assessment Time ◽  
Upper Gi Endoscopy ◽  
The Difference ◽  
Upper Gastrointestinal

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.

scholarly journals Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

2012 ◽  
Vol 49 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Judite Dietz ◽  
Jane Maria Ulbrich-Kulcynski ◽  
Katia Elisabete Pires Souto ◽  
Nelson Guardiola Meinhardt
Keyword(s):  
Bariatric Surgery ◽  
Intestinal Metaplasia ◽  
Gastrointestinal Endoscopy ◽  
Lymphoid Hyperplasia ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Digestive Endoscopy ◽  
Upper Digestive Endoscopy ◽  
H Pylori ◽  
Upper Gastrointestinal

CONTEXT: The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach. Atrophy, intestinal metaplasia and gastric cancer have been associated with infection by Helicobacter pylori. OBJECTIVES: To evaluate the presence of endoscopy findings and histological changes in morbid obese patients for the presence of inflammatory cells, inflammatory activity, lymphoid hyperplasia, H. pylori infection, atrophy and intestinal metaplasia in the gastric mucosa. METHODS: Upper digestive endoscopy and gastric histopathological were studied in 126 obese patients in the preoperative evaluation for bariatric surgery. RESULTS: Upper digestive endoscopy abnormalities were diagnosed in 73/126 (57.9%) patients. In three patients (2.4%) the upper gastrointestinal endoscopy diagnosed gastric ulcer and one patient (0.8%) had duodenal ulcer. The histopathological from gastric biopsies of these obese patients showed 65.1% of mucosa inflammation, inflammatory activity in 50.0%, infection by H. pylori in 53.2%, lymphoid hyperplasia in 50.0% and atrophy and/or intestinal metaplasia in 16.7%. CONCLUSIONS: In present study, with routine preoperative upper gastrointestinal endoscopy and histopathological examination, were detected 57.9% patients with endoscopy abnormalities, high prevalence of infection by H. pylori (53%) and 16.7% of gastric atrophy and/or intestinal metaplasia.

scholarly journals Upper gastrointestinal endoscopy findings in patient presenting with dyspepsia

2015 ◽  
Vol 2 (2) ◽  
pp. 19-22
Author(s):  
Roshan Shrestha ◽  
Sanjit Karki ◽  
Bimal Pandey ◽  
Yuba Raj Sharma
Keyword(s):  
Internal Medicine ◽  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Observational Study ◽  
Hiatus Hernia ◽  
Gastrointestinal Endoscopy ◽  
Health Sciences ◽  
Upper Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal ◽  
Made In

Introductions: The objective of this study was to evaluate the upper gastrointestinal endoscopy findings in patients presenting with dyspepsia.Methods: This retrospective observational study was conducted in Department of Internal Medicine, Patan Hospital from April 2013 to March 2014. Adult patients who underwent upper gastrointestinal endoscopy for dyspepsia were included in the study.Results: There were 2141 endoscopies (out of total 3195) performed for dyspepsia, male 996 (46.52 %), female 1145 (53.48%), mean age 39.37 years (SD ± 18.16). A single endoscopic diagnosis was made in 1991 (93%) and in rest, combinations of lesions were seen. Gastritis 892 (41.66%), oesophagitis 215 (10.04%), duodenal ulcer 100 (4.67%), gastro-duodenitis 85 (3.97%), hiatus hernia 82 (3.82%), gastric ulcer 46 (2.14%) and no lesions in 594 (27.74%) were seen.Conclusions: Gastritis followed by oesophagitis was seen in half of the dyspeptic, while a quarter had functional dyspepsia with normal findings.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page: 19-22

scholarly journals Evaluation of 105 Cases of Dyspepsia by Upper Gastrointestinal Endoscopy and Ultrasonography of Hepatobiliary System in a Rural Setting

2019 ◽  
Vol 11 (2) ◽  
pp. 25-29
Author(s):  
Azizun Nessa ◽  
Muhammad Rabiul Hossain ◽  
Md Habibur Rahman ◽  
SM Mizanur Rahman ◽  
Abdullah Al Mamun ◽  
...  
Keyword(s):  
Functional Dyspepsia ◽  
Gastrointestinal Endoscopy ◽  
Cross Sectional Study ◽  
Upper Gastrointestinal Endoscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Upper Gi ◽  
Dyspeptic Symptoms ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

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

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