Different Prevalence of Alarm, Dyspeptic and Reflux Symptoms in Patients with Cardia and Non-cardia Gastric Cancer

Background and Aims: Symptoms of patients with gastric cancer (GC) are often unspecific and differences in symptoms between patients with cardia and non-cardia GC have been poorly investigated. We aimed to characterize symptoms of patients with cardia and non-cardia GC. Methods: Patients with cardia (Siewert type II and III) and non-cardia GC were recruited in the German multicenter cohort of the Gastric Cancer Research (staR) study between 2013 and 2017. Alarm, dyspeptic and reflux symptoms at the time of presentation were documented using a self-administered questionnaire. Results: A completed self-administered questionnaire was available for 568/759 recruited patients (132 cardia GC, 436 non-cardia GC, male 61%, mean age 64 years). Dyspeptic symptoms were more common in patients with non-cardia GC (69.0 vs. 54.5%, p=0.0024). Cardia GC patients reported more frequently alarm symptoms (69.7 vs. 44.7%, p<0.0001), and were more likely to have Union for International Cancer Control (UICC) stage III-IV (54.1vs. 38.9%, p=0.0034). Especially, dysphagia and weight loss were more common in patients with cardia GC (49.2 vs. 6.4 %, p<0.0001 and 37.1 vs. 25.7%, p=0.02, respectively). No differences between the two groups were observed with respect to reflux symptoms. Patients with alarm symptoms were more likely to have UICC stage III-IV at presentation (69.4 vs. 42.9%, p<0.0001). Conclusions: In clinical practice the symptom pattern at presentation may serve as a hint for tumor localization. Despite the fact that they are common in the general population, dyspeptic symptoms offer a chance for earlier GC detection. Thus, in patients with dyspeptic symptoms who fail empiric approaches, endoscopy should not be delayed.

Prevention and treatment of gerd in patients with obesity undergoing gastroplication

The aim of the study was to study the advantages and disadvantages of laparoscopic gastric plication with the prevention and treatment of gastroesophageal reflux disease in the treatment of patients with overweight and obesity. From 2018 to the present, 24 patients have been observed who underwent laparoscopic gastric plication with the prevention and treatment of gastroesophageal reflux disease, of which 19 (79.2 %) women and 5 (20.8 %) men. The average age of patients is 41 ± 3.5 years. Indication for surgery: BMI > 35 kg/m² and the presence of GERD with unsuccessful conservative treatment or BMI > 35 kg/m² and the presence of HH with symptoms of GERD. The experience of surgical treatment of these 24 patients allows us to speak about the effectiveness of the use of gastroplication surgery with the prevention and treatment of gastroesophageal reflux disease with a combination of obesity and GERD. Dyspeptic symptoms are expected in some patients and are stopped in the early postoperative period with medication. The return of BMI to baseline in 3 (12.5 %) patients requires further study.

Draft Genome Sequence of Streptococcus salivarius AGIRA0003, Isolated from Functional Gastrointestinal Disorder Duodenal Tissue

Patients suffering functional dyspepsia symptoms have been shown to possess a greater relative abundance of Streptococcus compared to asymptomatic controls. Here, we describe the isolation and genomic features of a new Streptococcus isolate, from the duodenal tissue of a subject reporting dyspeptic symptoms, taxonomically assigned to Streptococcus salivarius and designated strain AGIRA0003.

A Case of the Therapeutic Effect of Nangan-jeon on Refractory Functional Dyspepsia Caused by “Liver-Kidney Deficiency Cold”

Objective: This study explored the clinical usefulness of Nangan-jeon decoction to treat refractory functional dyspepsia.Methods: A 61-year-old female had been suffering from severe functional dyspepsia for about 40 years, but the dyspeptic symptoms rapidly improved after taking Nangan-jeon decoction. The clinical outcome was assessed by the numerical rating scale (NRS) and the self-reporting method.Result: After there was no improvement from various herbal treatments in a department of a Korean college hospital, the patient moved to the author’s clinic. She had been diagnosed with the pattern identification of “liver-kidney deficiency cold” and prescribed with Nangan-jeon decoction. This herbal drug rapidly improved her dyspeptic symptoms, from NRS 10 to NRS 2 (after 3 weeks) and NRS 1 (after 7 weeks).Conclusion: This case report is the first to present the potential of Nangan-jeon decoction to improve refractory functional dyspepsia.

Clinical and Endoscopic Profile of Patients with Uninvestigated Dyspepsia: Experience from a Single Center

Background: Dyspepsia is undoubtedly one of the most common complaints that primary care physicians and gastroenterologists encounter in their clinical practice and encompasses a constellation of symptoms localized to the upper abdomen. While majority of these patients have “functional dyspepsia” with no endoscopic abnormality to account for their symptoms, benign conditions such as peptic ulcer disease and reflux esophagitis are the most common endoscopic lesions noted in “organic dyspepsia.” Aim: The aim of the study was to study the clinical and endoscopic profile of patients presenting with uninvestigated dyspepsia (patients with new or recurrent dyspeptic symptoms in whom no investigations have previously been undertaken) at our center. Materials and Methods:: A hospital-based retrospective observational study which included both inpatient and outpatient population over a period of 2 years, from December 2014 to November 2016. Patients’ charts from our hospital database were reviewed and data with regard to demographic variables, clinical and endoscopic profile of patients with uninvestigated dyspepsia was analyzed. Results A total of 280 patients with uninvestigated dyspepsia underwent esophagogastroduodenoscopy (EGD). The mean age of our study population was 45.2 years with 162 (58%) male and 118 (42%) female patients. The most common symptom was post-prandial fullness seen in 132 patients (47%). Endoscopy was reported as normal in 179 patients (64%) while 101 patients (36%) had an abnormal endoscopic finding with duodenal ulcer being the most common endoscopic abnormality (7.9%), followed by erosive gastritis (6.7%), reflux esophagitis (6.1%), gastric ulcer (3.9%), varioliform gastritis (3.2%), and esophageal/gastroesophageal junction malignancy (2.85%). Elderly (?50 years) patients with alarm symptoms such as weight loss, dysphagia, and/or anemia had a higher incidence of malignancy. Conclusion About two-thirds (64%) of our study population had functional o

Controversial and unsettled issues on diet therapy in functional dyspepsia

This review discusses the role of various foods in the onset of functional dyspepsia (FD) clinical symptoms. Currently, the ability of fats to cause a feeling of fulness in the epigastric area and nausea in these patients has been proven. The significance of other food products in the development of dyspeptic symptoms is evaluated inconsistently. A few conducted studies have not confirmed the effectiveness of the gluten-free diet and. the diet with low content of oligosaccharides, disaccharides, monosaccharides and polyols in the treatment of patients. The role of nutrition in the development of FD and the possibility of dietary therapy for this disease require further research.

Prevalence of Helicobacter pylori infection in adult patients with dyspeptic symptoms in Abdi Waluyo Hospital Jakarta from January 2017 to December 2019

Background: Helicobacter pylori infection is a global public health problem and may be present in more than half of the world’s population Prevalence in developing country higher compared to developed country. However, in Indonesia prevalence of Helicobacter pylori infection is still low compare to other Asian countries. This study aims to determine the prevalence of Helicobacter pylori infection in Abdi Waluyo Hospital Jakarta from January 2017 to December 2019.Method: In this cross sectional study, a total of 772 adult patients were tested using Urea Breath Test-14C for detection of isotopic carbon produced by Helicobacter pylori ability to broke down urea.Results: Prevalence of Helicobacter pylori infection in Abdi Waluyo hospital between January 2017 – December 2019 was 20.98% with endoscopic findings as follows: 17.48% with gastritis, 3.24% with gastric ulcers , 0.26% with gastric cancerConclusion: Increase prevalence of Helicobacter pylori infection every year in Abdi Waluyo hospital. It is suggested to perfom Urea Breath Test for adult patients with dyspeptic symptoms to screened Helicobacter pylori infection.

Diagnostic utility of alarm features in predicting malignancy in patients with dyspeptic symptoms

Background Clinical features are of modest benefit in determining the etiology of dyspepsia. Dyspeptic patients with alarm features are suspected to have malignancy; but the proportions of patients and true cutoff values of various quantitative parameters in predicting malignancy are explored to a lesser extent. Methods This is a prospective observational study of consecutive patients undergoing esophagogastroduodenoscopy (EGD) for dyspeptic symptoms. Patients’ alarm features and clinical details were recorded in a predesigned questionnaire. The diagnostic accuracy of alarm features in predicting malignancy was studied. Results Nine hundred patients, 678 (75.3%) males, with a mean (standard deviation [SD]) age of 44.6 (13.54) years were enrolled. Commonest indication for EGD was epigastric pain in 614 (68.2%) patients. Dyspepsia was functional in 311 (34.6%) patients. EGD revealed benign lesions in 340 (37.8%) and malignancy in 50 (5.5%) patients. Among the malignant lesions, gastric malignancy was present in 28 (56%) and esophageal malignancy in 20 (40%) patients. Alarm features were present in 206 (22.9%), out of which malignant lesions were seen in 46 (22.3%) patients. Altogether, the alarm features had a sensitivity of 92% and specificity of 81.2% for predicting malignancy. The sensitivity and specificity for weight loss were 76% and 90.8%, while that of abdominal mass were 10% and 99.9% respectively. Based on receiver operating characteristic curve, the optimal age for screening of malignancy was 46.5 years in this population. Conclusions Patients of age group 40 to 49 years with dyspeptic alarm symptoms (predominant weight loss) need prompt endoscopy to screen for malignancy. The alarm features are inexpensive screening tools, found to be useful in India, and should be utilized in countries with similar healthcare conditions and disease epidemiology.

Changes in the Seroprevalence of Helicobacter pylori among the Lithuanian Medical Students over the Last 25 Years and Its Relation to Dyspeptic Symptoms

Background and Objectives: The prevalence of Helicobacter pylori infection is decreasing in the Western world, while remaining high in developing countries. There is limited up-to-date information about the prevalence of H. pylori in Central and Eastern Europe. The aim of our study was to assess the seroprevalence of H. pylori and its trend over the past 25 years among students of the Lithuanian University of Health Sciences (LUHS) and to assess its relation to dyspeptic symptoms. Materials and Methods: In the years 1995, 2012, 2016 and 2020, students from Medical and Nursing Faculties of LUHS were tested for the presence of antibodies against H. pylori by performing serological tests from finger capillary blood. In addition, in the years 2012, 2016 and 2020, the students completed a gastrointestinal symptom rating scale (GSRS) questionnaire in order to assess dyspeptic symptoms. The study population consisted of 120 students in the year 1995 (mean age—21.3 ± 1.0 years), 187 students in the year 2012 (mean age—22.4 ± 0.7 years), 262 students in the year 2016 (mean age—20.4 ± 1.0 years) and 148 students in the year 2020 (mean age—20.4 ± 1.7 years). Results: The seroprevalence for H. pylori was positive in 62 (51.7%) students in 1995, in 57 (30.4%) students in 2012, in 69 (26.3%) students in 2016 and in 21 (14.2%) students in 2020. The statistically significant difference was found between all study years, except between 2012 and 2016. There were no significant differences in frequency and intensity of upper dyspeptic symptoms between H. pylori positive and negative students. Conclusions: Over the last 25 years the seroprevalence of H. pylori among students of LUHS has decreased significantly. No consistent differences in dyspeptic symptoms among H. pylori positive and negative subgroups were found.