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Yousif Alamen Abdalla H, Alhaboob Arabi N, Musaad AM, E Elsheikh A, Alrashidi N. Esophagogastroduodenoscopy in Patients With Dyspepsia: A Retrospective Study at a Tertiary Hospital. Cureus 2023; 15:e36520. [PMID: 37090398 PMCID: PMC10120605 DOI: 10.7759/cureus.36520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Background Recurrent upper abdominal pain or dyspepsia is one of the patients' most common chief complaints. This study correlates the symptoms of dyspepsia to esophagogastroduodenoscopy findings among Sudanese patients attending Soba University Hospital. Methods A retrospective observational study was conducted at Soba University Hospital from April 2019 to April 2020. Patients were selected according to inclusion and exclusion criteria. Each patient filled out a standardized data collection form with data on their demographics, symptoms, and endoscopic findings. A P-value of < 0.05 was considered statistically significant. Results The study included 142 patients, where 57.7% (n=82) were females, and 59.9% (n=85) of the study participants were of normal body mass index. In contrast, 57% of the study participants had a symptom duration of less than six months. Approximately 95.1% (n=135) suffered from heartburn, 80.3% (n=114) suffered from epigastric fullness, and 96.5% (n=137) suffered from epigastric pain. Seventy-eight point two percent (78.2%; n=111) who suffered from epigastric pain mentioned that it increased in intensity with food, 85.9% (n=121) who suffered from epigastric pain mentioned that it decreased in intensity with food, 54.2% (n=76) of the study participants suffered from regurgitation, 59.9% (n=85) of the study participants suffered from weight loss, 52.1% (n=73) of the study participants were using non-steroidal anti-inflammatory drugs (NSAIDs), 41.7% (n=59) of the study participants had normal esophagogastroduodenoscopy findings, followed by 35.9% (n=51) who had duodenitis or gastritis during the endoscopic assessment. Conclusion The study showed that esophagogastroduodenoscopy is not recommended in young patients without alarm symptoms who can be managed conservatively. However, every patient with alarming symptoms should have an esophagogastroduodenoscopy. Also, the study revealed that females and old-aged patients had higher rates of dyspeptic symptoms.
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Affiliation(s)
| | | | | | - Anas E Elsheikh
- Surgery, Faculty of Medicine, Soba University Hospital, Khartoum, SDN
| | - Nasser Alrashidi
- Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Al-Qassim, SAU
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Zádori N, Németh D, Frim L, Vörhendi N, Szakó L, Váncsa S, Hegyi P, Czimmer J. Dyspepsia-Like Symptoms in Helicobacter pylori-Negative Chronic Gastritis are Associated with ASCA-, ANCA-, and Celiac Seropositivity but Not with Other Autoimmune Parameters: A Single-Centre, Retrospective Cross-Sectional Study. Int J Gen Med 2022; 15:7789-7796. [PMID: 36258798 PMCID: PMC9572481 DOI: 10.2147/ijgm.s380419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/26/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Dyspeptic symptoms are frequent in the general population, with a high socioeconomic burden. Helicobacter pylori (H. pylori) might be a possible etiological factor; however, it is also common in H. pylori negative gastritis. Clarification of the underlying aetiology might be beneficial to set up the optimal treatment strategy for dyspepsia and chronic gastritis (CG) itself. We aimed to assess the prevalence of dyspeptic symptoms in patients with H. pylori negative CG and explore autoimmunity's possible role. Methods This retrospective study included data from patients with H. pylori negative CG. Exclusion criteria were (1) acute gastritis; (2) reactive gastropathy; (3) subjects without any serology testing results; (4) H. pylori positivity; (5) presence of atrophy, intestinal metaplasia (IM), gastroesophageal reflux disease (GERD), ulcer, or cancer. The following endpoints were assessed (1) the rate of dyspepsia-like symptoms; (2) association between dyspepsia and autoimmune disease-related seromarker positivity (AISP); (3) frequency of other symptoms in CG and its association with AISP; (4) location of the inflammation and its association with AISP. Results From a total of 285 patients, 175 were included in this study. Among these patients, 95 experienced dyspeptic symptoms (54.29%) and were associated more with AISP (p = 0.012), especially with celiac seropositivity (p = 0.045), anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) positivity (p = 0.043). A significant association was not found with other tested autoimmune (AI)-related antibody positivity. Conclusion Positivity of seromarkers of autoimmune diseases in chronic gastritis may predispose to have dyspeptic symptoms and may be the causative factor behind some cases of uninvestigated dyspepsia. These data suggest that further prospective studies are needed to clarify whether screening for autoantibodies in patients with dyspepsia is cost-effective and helps the earlier diagnosis of autoimmune diseases.
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Affiliation(s)
- Noémi Zádori
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Dávid Németh
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Levente Frim
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nóra Vörhendi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,János Szentágothai Research Centre, University of Pécs, Pécs, Hungary,Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - József Czimmer
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary,Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary,Correspondence: József Czimmer, First Department of Medicine, University of Pécs Medical School, Ifjúság street 13, Pécs, H-7624, Hungary, Email
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Oluseyi Akande K, Oke TO, Afuwape O, Adigun TA, Akere A, Aje A, Ola SO, Otegbayo JA. Spectrum and pattern of distribution of findings in patients with dyspepsia undergoing oesophago-gastro-duodenoscopy at a Tertiary Hospital in Ibadan, south west, Nigeria. ALEXANDRIA JOURNAL OF MEDICINE 2021. [DOI: 10.1080/20905068.2021.1913890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
Affiliation(s)
- Kolawole Oluseyi Akande
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Temitope Olufemi Oke
- Department of Medicine, Gastroenterology & Hepatology Unit, University College Hospital, Ibadan, Nigeria
| | - Oludolapo Afuwape
- Department of Surgery, College of Medicine, Division of Gastrointestinal Surgery, University of Ibadan, Ibadan, Nigeria
| | | | - Adegboyega Akere
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Ajibola Aje
- Department of Medicine, Gastroenterology & Hepatology Unit, University College Hospital, Ibadan, Nigeria
| | - Samuel Olawale Ola
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
| | - Jesse Abiodun Otegbayo
- Department of Medicine, College of Medicine, Gastroenterology & Hepatology Unit, University of Ibadan, Ibadan, Nigeria
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Sharma P, Salaria S, Manrai M, Srivastava S, Kumar D, Singh A. Helicobacter pylori infection in non-ulcer dyspepsia: A cross-sectional study. Med J Armed Forces India 2021; 78:180-184. [PMID: 35463542 PMCID: PMC9023538 DOI: 10.1016/j.mjafi.2020.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/22/2020] [Indexed: 11/28/2022] Open
Abstract
Background Helicobacter pylori infection has been known to be associated with dyspepsia for more than two decades; however, studies on this topic in India are limited. This study was carried out to estimate the Helicobacter pylori infection rates in non-ulcer dyspepsia. Methods Helicobacter pylori infection rates detected by rapid urease test (RUT) positivity were analyzed in 235 patients presenting to a tertiary care center with dyspepsia having no evidence of peptic ulcer disease on esophagogastroduodenoscopy. Results In this study, the prevalence of Helicobacter pylori infection diagnosed by the RUT was found to be 40.85%. Gender-based prevalence was found to be 40.14% and 41.93% for men and women, respectively. The highest prevalence was found in the age group of 30-39 years. The most common area of involvement was the isolated antrum of the stomach as seen in 93 patients. Conclusion This study shows a modest RUT positivity rate for Helicobacter pylori infection with the commonest site of involvement being the antrum of the stomach. Further studies will be needed to assess the prevalence of Helicobacter pylori in the community to analyze the extent of infection.
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Affiliation(s)
- P.K. Sharma
- Commandant, 159 General Hospital, C/o 56 APO, India
| | - S. Salaria
- Medical Cadet, Armed Forces Medical College, Pune, India
| | - M. Manrai
- Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India
- Corresponding author.
| | - S. Srivastava
- Senior Advisor (Medicine) & Gastroenterologist, Medical Division, Command Hospital (Southern Command), Pune, India
| | - D. Kumar
- Senior Advisor (Medicine) & Gastroenterologist, Medical Division, Command Hospital (Northern Command), Udhampur, India
| | - A.R. Singh
- Graded Specialist (Medicine), Base Hospital Barrackpore, West Bengal, India
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Wei Z, Yang Q, Yang Q, Yang J, Tantai X, Xing X, Xiao C, Pan Y, Liu N, Wang J. Rome III, Rome IV, and Potential Asia Symptom Criteria for Functional Dyspepsia Do Not Reliably Distinguish Functional From Organic Disease. Clin Transl Gastroenterol 2020; 11:e00278. [PMID: 33512804 PMCID: PMC7721216 DOI: 10.14309/ctg.0000000000000278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Although the Rome criteria were created primarily for research purposes, it was an important question whether the Rome criteria can distinguish organic dyspepsia from functional dyspepsia (FD). We evaluated the accuracy of the Rome IV criteria in identifying patients with FD and compared the differences between the Rome IV, Rome III, and potential Asia criteria in identifying patients with FD. METHODS In this cross-sectional study, we analyzed data from patients who met the inclusion and exclusion criteria from March 2018 to January 2019 at 2 tertiary hospitals. RESULTS A total of 600 patients were enrolled in this study, including 381 individuals met the Rome IV criteria for FD, 438 individuals met the Rome III criteria for FD, and 525 individuals met the potential Asia criteria for FD. The Rome IV criteria identified patients with FD with 67.3% sensitivity and 38.4% specificity, and the positive and negative likelihood ratios of FD identified by Rome IV criteria were 1.09 (95% confidence interval 0.97-1.24) and 0.85 (95% confidence interval 0.67-1.08), respectively. There was no significant difference in the area under Rome IV, Rome III, or potential Asia criteria receiver operating characteristic curves in identifying FD (P > 0.05). DISCUSSION The Rome IV criteria were no better than the Rome III or potential Asia criteria in identifying FD and were not helpful in identifying patients with FD. Hence, although the Rome criteria remain useful for defining patients with FD for inclusion into clinical treatment trials, they should not be used for diagnosing FD.
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Affiliation(s)
- Zhongcao Wei
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Qian Yang
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Qi Yang
- Department of Gastroenterology, Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Juan Yang
- Department of Gastroenterology, Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Xinxing Tantai
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Xin Xing
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Cailan Xiao
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Yanglin Pan
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, Shaanxi, China
| | - Na Liu
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
| | - Jinhai Wang
- Department of Gastroenterology, The Second Affiliated Hospital, Xi'an Jiaotong University, Shaanxi, China
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Gastroesophageal Reflux Disease-Functional Dyspepsia Overlap: Do Birds of a Feather Flock Together? Am J Gastroenterol 2020; 115:1167-1182. [PMID: 32453043 DOI: 10.14309/ajg.0000000000000619] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are 2 of the most prevalent upper gastrointestinal (GI) disorders in the Western world. Previous Rome definitions excluded patients with predominant heartburn from the definition of FD because they were considered to have GERD. However, more recent studies showed that heartburn and acid regurgitation are also common symptoms in patients with FD. The aim of this study is to provide an overview of the prevalence of overlap between GERD and FD, the underlying pathophysiology and implications for treatment. METHODS A review of the literature was performed using the PubMed database, and a meta-analysis with random effects model was completed. RESULTS This review showed considerable overlap between GERD and FD. A meta-analysis on the data included in this review showed 7.41% (confidence interval [CI]: 4.55%-11.84%) GERD/FD overlap in the general population, 41.15% (CI: 29.46%-53.93%) GERD with FD symptoms, and 31.32% (CI: 19.43%-46.29%) FD with GERD symptoms. Although numerous committees and consensus groups attempted to develop uniform definitions for the diagnosis of GERD and FD, various diagnostic criteria are used across studies and clinical trials (frequency, severity, and location of symptoms). Several studies showed that the overlap between GERD and FD can be explained by a shared pathophysiology, including delayed gastric emptying and disturbed gastric accommodation. DISCUSSION For diagnoses of GERD and FD, uniform definitions that are easy to implement in population studies, easy to interpret for physicians, and that need to be well explained to patients to avoid overestimation or underestimation of true prevalence are needed. Both GERD and FD coexist more frequently than expected, based on coincidence, suggesting a potential pathophysiological link. More research is needed to explore the common GERD/FD overlap population to identify the underlying pathophysiological mechanisms, which may lead to a more effective therapeutic approach.
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de Oliveira FAB, Mazo DF. Direct access endoscopy in a Brazilian public healthcare facility: comparable results with specialist referred endoscopy. Scand J Gastroenterol 2020; 55:970-975. [PMID: 32619367 DOI: 10.1080/00365521.2020.1787500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Direct access endoscopy (DAE) is the procedure performed without the pre-evaluation of the patient by a specialist. It is widely available in many medical services around the world, but there is lack of data about this strategy in the setting of the public health system in Brazil. Therefore, the aim of this study is to compare the main endoscopic findings of upper gastrointestinal endoscopy requested through DAE and by specialists. METHODS Longitudinal, retrospective single center study in patients who underwent upper digestive endoscopy in a public healthcare facility at the southern region of the state of Mato Grosso, Brazil, from August 2011 to December 2018. Age, gender, modality of endoscopy request (DAE or endoscopy requested by specialists), and endoscopic findings were analyzed. RESULTS A total of 2810 patients were included. Most of them were female 65.23% (1833), mean age was 47.36 years, and 50.71% of the exams (1425) were DAE. Only 4.62% of the exams had normal reports. The most frequent endoscopic findings were gastritis (91.99%), bulboduodenitis (43.59%) and reflux esophagitis (14.76%). Patients who underwent endoscopy requested by specialists were older (50.25 ± 16.57 vs. 44.55 ± 16.31 years, p < .0001) and more frequently men (36.61 vs. 32.98%, p = .0437) in comparison to DAE. However, endoscopic findings were similar in both groups. CONCLUSION This study shows that direct access upper endoscopy had comparable results to specialist requested endoscopy in a public healthcare facility in the southern region of the state of Mato Grosso, Brazil.
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Affiliation(s)
- Fernando Augusto Borges de Oliveira
- School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Medicine Course, Institute of Exact and Natural Sciences (ICEN), Federal University of Rondonópolis (UFR), Rondonópolis, Brazil
| | - Daniel F Mazo
- Division of Gastroenterology (Gastrocentro), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.,Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine (FMUSP), Sao Paulo, Brazil
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Oung B, Chea K, Oung C, Saurin JC, Ko CW. Endoscopic yield of chronic dyspepsia in outpatients: A single-center experience in Cambodia. JGH OPEN 2020; 4:61-68. [PMID: 32055699 PMCID: PMC7008163 DOI: 10.1002/jgh3.12210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/18/2019] [Accepted: 05/04/2019] [Indexed: 11/06/2022]
Abstract
Background and Aim The diagnostic evaluation and management of patients with chronic dyspepsia may differ geographically according to patient age, prevalence of Helicobacter pylori or parasitic infection, and risk of gastric cancer. The characteristics and appropriate investigation of Cambodian patients with dyspepsia have not previously been studied. The aim of this study was to investigate the characteristics of Cambodian patients with chronic dyspepsia, the yield of upper endoscopy in these patients, and the value of alarm features in identifying patients with organic causes of dyspepsia. Methods We conducted a retrospective, single-center study of 1231 adults with chronic dyspepsia who underwent upper endoscopy. We compared clinical characteristics, H. pylori prevalence, and endoscopic and histological findings of patients with functional or organic causes of dyspepsia. This study was approved by the National Ethics Committee for Health Research. Results The majority of patients had overlapping symptoms of epigastric pain/burning and postprandial fullness/early satiety (40.6%), followed by epigastric pain/burning alone (29.7%) and postprandial fullness/early satiety alone (29.7%). Organic lesions were diagnosed in 6.9% of patients. The overall prevalence of H. pylori infection was 46% and was similar in the three clinical subgroups. The sensitivity and specificity of alarm features for organic causes of dyspepsia were 14 and 96%, respectively. The majority of patients with gastric cancer were 40 years of age or older. Conclusions The majority of patients with chronic dyspepsia seen at our outpatient center were diagnosed with functional or H. pylori-associated dyspepsia. The presence of alarm features was not sensitive or specific for differentiating organic and functional dyspepsia.
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Affiliation(s)
- Borathchakra Oung
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital Hospices civils de Lyon Lyon France.,CHAKRA GI Clinic Phnom Penh Cambodia.,GI and Liver Unit Calmette Hospital Phnom Penh Cambodia
| | - Khang Chea
- CHAKRA GI Clinic Phnom Penh Cambodia.,GI and Liver Unit Calmette Hospital Phnom Penh Cambodia
| | - Chakravuth Oung
- CHAKRA GI Clinic Phnom Penh Cambodia.,GI and Liver Unit Calmette Hospital Phnom Penh Cambodia.,Faculty of Medicine University of Health Sciences Phnom Penh Cambodia.,Cambodian Association of Gastrointestinal Endoscopy Seattle Washington USA
| | - Jean-Christophe Saurin
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital Hospices civils de Lyon Lyon France.,GI and Liver Unit Calmette Hospital Phnom Penh Cambodia
| | - Cynthia W Ko
- Division of Gastroenterology University of Washington Seattle Washington USA
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A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study. Dig Dis Sci 2018; 63:3442-3447. [PMID: 30109577 DOI: 10.1007/s10620-018-5245-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 08/07/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The guidelines for performing endoscopy in dyspeptic patients based on clinical parameters alone have shown variable performance, and there is a need for better prediction tools. AIM We aimed to prospectively develop and validate a simple clinical-cum-laboratory test-based scoring model to identify dyspeptic patients with high risk of upper gastrointestinal malignancy (UGIM). METHODS Adult patients with dyspeptic symptoms were prospectively recruited over 5 years. Clinical details including alarm features were recorded, and blood tests for hemoglobin and albumin were done before endoscopy. The presence of UGIM was the primary outcome. Risk factors for UGIM were assessed, and based on the OR of significant factors, a predictive scoring model was constructed. ROC curve was plotted to identify optimal cutoff score. The model was validated using bootstrapping technique. RESULTS The study included 2324 patients (41.9 ± 12.8 years; 33.4% females). UGIM was noted in 6.8% patients. The final model had following five positive predictors for UGIM-age > 40 years (OR 3.3, score 1); albumin ≤ 3.5 g% (OR 3.4, score 1); Hb ≤ 11 g% (OR 3.3, score 1); alarm features (OR 5.98, score 2); recent onset of symptoms (OR 8.7, score 3). ROC curve had an impressive AUC of 0.9 (0.88-0.93), and a score of 2 had 92.5% sensitivity in predicting UGIM. Validation by bootstrapping showed zero bias, which further strengthened our model. CONCLUSION This simple clinical-cum-laboratory test-based model performed very well in identifying dyspeptic patients at risk of UGIM. This can serve as a useful decision-making tool for referral for endoscopy.
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Abstract
Introduction Renal transplantation is the definitive treatment for end stage renal disease. Patients subjected to transplantation require lifelong immunosuppression and are prone to several gastrointestinal disorders. Dyspepsia is a common disorder in these patients. The objective of this study was to determine factors leading to dyspepsia in renal (kidney) transplant recipients. Methods It was a cross sectional study conducted at department of hepatogastroenterology and transplant sciences, SIUT Karachi, from 1-6-15 to 1-12-15 for six months. All renal transplanted patients having dyspeptic symptoms for more than 6 weeks. EGD was performed, biopsy specimens obtained from antrum and duodenum, these were sent for histopathological examination. Frequency and percentages were obtained for categorical variables, mean ± SD was calculated for continuous variables. Chi square test was used for categorical variable and student t-test for continuous variables. Results Ninety patients were included in the study out of which 64 (71.1%) were males, mean age was 35.82 ± 10.04 years (range: 18-65 years). Gastritis (non H.pylori associated) in 78 (78.6%), duodenitis in 35 (38.9%) and H. pylori infection in 29 (32.2%), renal transplant recipients. Most of the patients belonged to Sindhi ethnicity, 27 (30%), followed by Punjabi. Hypertension was the most common co-morbid condition in our patients found in 29 (32.2%), while most of them don't have any co morbid condition. Duodenitis was found to be associated with tacrolimus use (p = 0.037). Conclusion Gastritis is the most common factor accountable for this symptoms, followed by duodenitis and H. Pylori. Patients taking tacrolimus as immunosuppressant are more prone to develop duodenitis.
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Affiliation(s)
- Aisha Nazeer
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi
| | - Ayesha Aslam Rai
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi
| | - Nasir Hassan Luck
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi
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Carmona-Sánchez R, Gómez-Escudero O, Zavala-Solares M, Bielsa-Fernández M, Coss-Adame E, Hernández-Guerrero A, Huerta-Iga F, Icaza-Chávez M, Lira-Pedrín M, Lizárraga-López J, López-Colombo A, Noble-Lugo A, Pérez-Manauta J, Raña-Garibay R, Remes-Troche J, Tamayo J, Uscanga L, Zamarripa-Dorsey F, Valdovinos Díaz M, Velarde-Ruiz Velasco J. Mexican consensus on dyspepsia. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2017. [DOI: 10.1016/j.rgmxen.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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12
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Jarbøl DE, Rasmussen S, Balasubramaniam K, Elnegaard S, Haastrup PF. Self-rated health and functional capacity in individuals reporting overlapping symptoms of gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome - a population based study. BMC Gastroenterol 2017; 17:65. [PMID: 28521729 PMCID: PMC5437406 DOI: 10.1186/s12876-017-0622-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/10/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal conditions with a significant impact on daily life. The objectives were to analyse general self-rated health and self-reported functional capacity in adults meeting the criteria for GERD, FD and IBS, respectively, and in individuals who meet the criteria for more than one of the conditions. METHODS A nationwide study of 100,000 individuals aged 20 years and above, randomly selected in the general Danish population. A web-based questionnaire survey formed the basis of this study. Questions regarding FD and IBS were extracted from the ROME III adult questionnaire. Questions regarding GERD were developed based on the Montreal definition. Self-rated health and functional capacity was measured by single global questions. RESULTS Respondents meeting the criteria for either GERD, FD or IBS have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to individuals not experiencing these functional gastrointestinal conditions. Furthermore, respondents with overlapping gastrointestinal (GI) symptom complexes have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to respondents with symptoms compatible with only one of the symptom complexes. CONCLUSIONS This study demonstrates that individuals experiencing symptoms of GERD, FD or IBS report poor self-rated health as well as impaired functional capacity. The impact on self-rated health and functional capacity is highest among individuals experiencing overlapping symptoms of GERD, FD and IBS.
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Affiliation(s)
- Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Sandra Elnegaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Peter Fentz Haastrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
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Jarbøl DE, Rasmussen S, Balasubramaniam K, Elnegaard S, Haastrup PF. Self-rated health and functional capacity in individuals reporting overlapping symptoms of gastroesophageal reflux disease, functional dyspepsia and irritable bowel syndrome - a population based study. BMC Gastroenterol 2017; 17:65. [PMID: 28521729 PMCID: PMC5437406 DOI: 10.1186/s12876-017-0622-9;] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/10/2017] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal conditions with a significant impact on daily life. The objectives were to analyse general self-rated health and self-reported functional capacity in adults meeting the criteria for GERD, FD and IBS, respectively, and in individuals who meet the criteria for more than one of the conditions. METHODS A nationwide study of 100,000 individuals aged 20 years and above, randomly selected in the general Danish population. A web-based questionnaire survey formed the basis of this study. Questions regarding FD and IBS were extracted from the ROME III adult questionnaire. Questions regarding GERD were developed based on the Montreal definition. Self-rated health and functional capacity was measured by single global questions. RESULTS Respondents meeting the criteria for either GERD, FD or IBS have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to individuals not experiencing these functional gastrointestinal conditions. Furthermore, respondents with overlapping gastrointestinal (GI) symptom complexes have significantly higher odds of reporting poor self-rated health and impaired functional capacity compared to respondents with symptoms compatible with only one of the symptom complexes. CONCLUSIONS This study demonstrates that individuals experiencing symptoms of GERD, FD or IBS report poor self-rated health as well as impaired functional capacity. The impact on self-rated health and functional capacity is highest among individuals experiencing overlapping symptoms of GERD, FD and IBS.
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Affiliation(s)
- Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Sandra Elnegaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
| | - Peter Fentz Haastrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9A, DK-5000 Odense C., Denmark
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Carmona-Sánchez R, Gómez-Escudero O, Zavala-Solares M, Bielsa-Fernández MV, Coss-Adame E, Hernández-Guerrero AI, Huerta-Iga F, Icaza-Chávez ME, Lira-Pedrín MA, Lizárraga-López JA, López-Colombo A, Noble-Lugo A, Pérez-Manauta J, Raña-Garibay RH, Remes-Troche JM, Tamayo JL, Uscanga LF, Zamarripa-Dorsey F, Valdovinos Díaz MA, Velarde-Ruiz Velasco JA. Mexican consensus on dyspepsia. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2017; 82:309-327. [PMID: 28413079 DOI: 10.1016/j.rgmx.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/19/2017] [Accepted: 01/31/2017] [Indexed: 02/07/2023]
Abstract
Since the publication of the 2007 dyspepsia guidelines of the Asociación Mexicana de Gastroenterología, there have been significant advances in the knowledge of this disease. A systematic search of the literature in PubMed (01/2007 to 06/2016) was carried out to review and update the 2007 guidelines and to provide new evidence-based recommendations. All high-quality articles in Spanish and English were included. Statements were formulated and voted upon using the Delphi method. The level of evidence and strength of recommendation of each statement were established according to the GRADE system. Thirty-one statements were formulated, voted upon, and graded. New definition, classification, epidemiology, and pathophysiology data were provided and include the following information: Endoscopy should be carried out in cases of uninvestigated dyspepsia when there are alarm symptoms or no response to treatment. Gastric and duodenal biopsies can confirm Helicobacter pylori infection and rule out celiac disease, respectively. Establishing a strong doctor-patient relationship, as well as dietary and lifestyle changes, are useful initial measures. H2-blockers, proton-pump inhibitors, prokinetics, and antidepressants are effective pharmacologic therapies. H.pylori eradication may be effective in a subgroup of patients. There is no evidence that complementary and alternative therapies are beneficial, with the exception of Iberogast and rikkunshito, nor is there evidence on the usefulness of prebiotics, probiotics, or psychologic therapies. The new consensus statements on dyspepsia provide guidelines based on up-to-date evidence. A discussion, level of evidence, and strength of recommendation are presented for each statement.
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Affiliation(s)
| | - O Gómez-Escudero
- Clínica de Gastroenterología, Endoscopia Digestiva y Motilidad Gastrointestinal, Hospital Ángeles Puebla, Puebla, Puebla, México
| | - M Zavala-Solares
- Unidad de Motilidad Gastrointestinal, Hospital General de México, Ciudad de México, México
| | - M V Bielsa-Fernández
- Unidad de Pacientes en Estudio, Universidad Autónoma de Guadalajara, Zapopán, Jalisco, México
| | - E Coss-Adame
- Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - A I Hernández-Guerrero
- Departamento de Endoscopia, Instituto Nacional de Cancerología, Ciudad de México, México
| | - F Huerta-Iga
- Servicio de Endoscopia y Fisiología Digestiva, Hospital Ángeles Torreón, Torreón, Coahuila, México
| | | | - M A Lira-Pedrín
- Hospital Ángeles Tijuana, Tijuana, Baja California Norte, México
| | - J A Lizárraga-López
- Servicio de Endoscopia, Unidad Médica de Atención Ambulatoria 265, Instituto Mexicano del Seguro Social, Culiacán, Sinaloa, México
| | - A López-Colombo
- Dirección de Educación e Investigación en Salud, UMAE Hospital de Especialidades del Centro Médico Nacional Manuel Ávila Camacho, IMSS, Puebla, Puebla, México
| | - A Noble-Lugo
- Servicio de Gastroenterología, Hospital Español de México, Ciudad de México, México
| | - J Pérez-Manauta
- Departamento de Enseñanza e Investigación, Hospital Español de México, Ciudad de México, México
| | - R H Raña-Garibay
- Servicio de Gastroenterología, Hospital Español de México, Ciudad de México, México
| | - J M Remes-Troche
- Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México
| | - J L Tamayo
- Servicio de Gastroenterología y Endoscopia Gastrointestinal, Hospital Civil de Culiacán, Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - L F Uscanga
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - F Zamarripa-Dorsey
- Departamento de Gastroenterología, Hospital Juárez, Ciudad de México, México
| | - M A Valdovinos Díaz
- Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - J A Velarde-Ruiz Velasco
- Departamento de Gastroenterología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México
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Prospective identification of Helicobacter pylori in routine gastric biopsies without reflex ancillary stains is cost-efficient for our health care system. Hum Pathol 2016; 58:90-96. [DOI: 10.1016/j.humpath.2016.07.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/25/2016] [Accepted: 07/28/2016] [Indexed: 01/23/2023]
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Abstract
Traumatic brain injury (TBI) is a complex disorder that affects millions of people worldwide. The complexity of TBI partly stems from the fact that injuries to the brain instigate non-neurological injuries to other organs such as the intestine. Additionally, genetic variation is thought to play a large role in determining the nature and severity of non-neurological injuries. We recently reported that TBI in flies, as in humans, increases permeability of the intestinal epithelial barrier resulting in hyperglycemia and a higher risk of death. Furthermore, we demonstrated that genetic variation in flies is also pertinent to the complexity of non-neurological injuries following TBI. The goals of this review are to place our findings in the context of what is known about TBI-induced intestinal permeability from studies of TBI patients and rodent TBI models and to draw attention to how studies of the fly TBI model can provide unique insights that may facilitate diagnosis and treatment of TBI.
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Affiliation(s)
| | - Barry Ganetzky
- a Laboratory of Genetics; University of Wisconsin-Madison ; Madison , WI USA
| | - David A Wassarman
- a Laboratory of Genetics; University of Wisconsin-Madison ; Madison , WI USA
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Paediatric Rome III Criteria-Related Abdominal Pain Is Associated With Helicobacter pylori and Not With Calprotectin. J Pediatr Gastroenterol Nutr 2016; 63:417-22. [PMID: 26913755 DOI: 10.1097/mpg.0000000000001172] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Abdominal pain-related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level. METHODS Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex-matched healthy controls. H pylori has been detected by biopsy-based tests and stool-antigen detection, faecal calprotectin by enzyme-linked immunosorbent assay. RESULTS A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8-18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9-49.7, P = 0.00001) than in controls and not in cases with other well-recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8-8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8-11.3). Gastritis features were more frequent in H pylori-infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007). CONCLUSIONS H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain-related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.
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Abstract
Introduction Many clinicians consider chronic gastritis to be equivalent to Helicobacter pylori infection. However, it is known that there are numerous other causes of the condition. Aim Determination of the incidence of gastritis in patients with dyspepsia referred for diagnostic endoscopy of the upper part of the digestive tract, identification of the parts of the stomach most frequently affected by the inflammation, as well as the impact of an insufficient number of collected samples on the correct diagnosis. Material and methods Upper gastrointestinal endoscopy due to dyspepsia was performed in 110 patients. In the course of gastroscopy two biopsy specimens were collected for histopathological examination and towards H. pylori infection from the lesser and greater curvature in the antrum 3 cm from the pyloric sphincter, in the body – 4 cm proximally to the stomach angular incisure on the lesser curvature, and in the middle of the greater curvature, as well as in the subcardiac region on the side of the lesser and greater curvature. Results In patients with dyspepsia H. pylori-negative chronic gastritis is more common than gastritis with accompanying H. pylori infection. Collection of too small a number of biopsy specimens results in failure to detect inflammatory changes and/or H. pylori infection, which may be limited to one part of the stomach. Biopsy specimens of gastric mucosa should be collected in compliance with the assumptions of the Sydney System. Helicobacter pylori infection in people with dyspepsia is now being reported more rarely than in the past (36%). Conclusions In patients with dyspepsia chronic H. pylori-negative gastritis is more common than gastritis with an accompanying H. pylori infection. Helicobacter pylori infection is not always equivalent to the presence of chronic gastritis.
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Nkurunziza A, Dusabejambo V, Everhart K, Bensen S, Walker T. Validation of the Kinyarwanda-version Short-Form Leeds Dyspepsia Questionnaire and Short-Form Nepean Dyspepsia Index to assess dyspepsia prevalence and quality-of-life impact in Rwanda. BMJ Open 2016; 6:e011018. [PMID: 27266772 PMCID: PMC4908900 DOI: 10.1136/bmjopen-2015-011018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda. SETTING A single, tertiary care centre in Rwanda. PARTICIPANTS 200 consecutive Kinyarwanda-speaking patients referred to endoscopy (100 patients) or medical outpatients (100 patients). INTERVENTIONS Kinyarwanda versions of the SF-LDQ and SF-NDI were developed from English versions by translation, with back translation, crosschecking and pilot testing. Study participants completed these questionnaires at enrolment (time 1), and then completed the surveys again with blinded phone interviewers 3 days later (time 2). 20 randomly selected participants, diagnosed with a peptic ulcer on index endoscopy, completed a third survey by phone at day 30 (time 3), after therapy. PRIMARY OUTCOME MEASURES Internal consistency at time 1 (by Cronbach's α) and test-retest reliability between time 1 and time 2 (Spearman's correlation coefficient) for translated SF-LDQ and SF-NDI; validity versus clinical diagnosis (by receiver operating characteristic (ROC) curve) and responsiveness to treatment for SF-LDQ (by change in mean score). All outcomes were measured as per protocol. RESULTS Cronbach's α of the translated SF-LDQ was 0.93, showing high internal consistency. Spearman's correlation coefficient comparing time 1 and time 2 was 0.978 (p<0.001), demonstrating high reliability. Cronbach's α for the translated SF-NDI was 0.92. A cut-off score of 16 on the SF-LDQ showed a sensitivity of 97% and a specificity of 71% for the diagnosis of dyspepsia, correctly classifying 89% of patients. In the responsiveness analysis, the mean SF-LDQ score was reduced from 20.1 prior to treatment to 13.9 after 30 days of treatment (p=0.003). CONCLUSIONS The Kinyarwanda versions of the SF-LDQ and SF-NDI were valid, reliable and responsive to treatment.
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Affiliation(s)
- Arcade Nkurunziza
- College of Medicine and Health Sciences, University of Rwanda,Huye, Rwanda
| | - Vincent Dusabejambo
- College of Medicine and Health Sciences, University of Rwanda,Huye, Rwanda
- Kigali University Teaching Hospital, Kigali, Rwanda
| | - Kelly Everhart
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Steve Bensen
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Tim Walker
- College of Medicine and Health Sciences, University of Rwanda,Huye, Rwanda
- Butare University Teaching Hospital, Huye, Rwanda
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Zhou LB, Wu J, Lu Y, Ai QX. Effects of humanistic intervention in patients with functional dyspepsia with depression. Shijie Huaren Xiaohua Zazhi 2016; 24:1098-1102. [DOI: 10.11569/wcjd.v24.i7.1098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effects of humanistic intervention in patients with functional dyspepsia with depression.
METHODS: One hundred patients with functional dyspepsia with depression treated at our hospital were randomly divided into a control group and a study group, with 50 cases in each group. The control group received routine nursing care, and the study group received humanistic nursing intervention on the basis of routine nursing. Depression and anxiety levels, adherence to treatment, common digestion symptoms and patients' satisfaction with nursing care were compared between the two groups.
RESULTS: The depression and anxiety levels and the incidence of dyspeptic symptoms were significantly lower in the study group than in the control group (P < 0.05). The adherence to treatment and patients' satisfaction with nursing care were significantly higher in the study group than in the control group (58.0% vs 30.0%, 92.0% vs 58.0%, P < 0.05 for both).
CONCLUSION: Humanistic nursing intervention can significantly reduce the depression and anxiety levels and the incidence of the dyspeptic symptoms, and improve the adherence to treatment and the patients' satisfaction with nursing care in patients with functional dyspepsia with depression.
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Vetro C, Bonanno G, Giulietti G, Romano A, Conticello C, Chiarenza A, Spina P, Coppolino F, Cunsolo R, Raimondo FD. Rare gastrointestinal lymphomas: The endoscopic investigation. World J Gastrointest Endosc 2015; 7:928-949. [PMID: 26265987 PMCID: PMC4530327 DOI: 10.4253/wjge.v7.i10.928] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal lymphomas represent up to 10% of gastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma. However, the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization. Due to their rarity and the multifaceted histology, an endoscopic classification has not been validated yet. This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up, according to the involved site and lymphoma subtype. Existing, new and emerging endoscopic technologies have been examined. In particular, we investigated the diagnostic, prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas, lymphomatous polyposis and mantle cell lymphoma, follicular lymphoma, plasma cell related disease, gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract. Contrarily to more frequent gastrointestinal lymphomas, data about rare lymphomas are mostly extracted from case series and case reports. Due to the data paucity, a synergism between gastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinical and prognostic features are different from nodal and extranodal or the bone marrow (in case of plasma cell disease) counterpart. Therefore, the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
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Rasmussen S, Jensen TH, Henriksen SL, Haastrup PF, Larsen PV, Søndergaard J, Jarbøl DE. Overlap of symptoms of gastroesophageal reflux disease, dyspepsia and irritable bowel syndrome in the general population. Scand J Gastroenterol 2015; 50:162-9. [PMID: 25525975 DOI: 10.3109/00365521.2014.983157] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common functional gastrointestinal conditions with significant impact on the daily lives of individuals. The objective was to investigate the prevalence and overlap of the three conditions in a Western general population. MATERIAL AND METHODS A nationwide study of 100,000 individuals 20 years and above, randomly selected in the general population. A web-based questionnaire survey formed the basis of this study. Questions regarding FD and IBS were extracted from the ROME III adult questionnaire. Questions regarding GERD were developed based on the Montreal definition. Prevalence estimates for GERD, FD IBS were calculated in total and for each sex separately and for four age groups. A Venn diagram was constructed, illustrating the overlap between the three conditions. RESULTS The overall response rate was 52.2%. The prevalence of GERD, FD and IBS was 11.2%, 7.7% and 10.5%, respectively, and overlap between two or three of these conditions was seen among 6.5% of the respondents. Among individuals meeting the criteria of one or more of the conditions GERD, FD and IBS, 30.7% had overlap between two or all three conditions. CONCLUSION GERD, FD and IBS are common conditions in the general population and the overlap between these conditions is also quite common. When diagnosing patients with GERD, FD and IBS, physicians should keep in mind that these patients could be suffering from more than one of these conditions.
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Affiliation(s)
- Sanne Rasmussen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark , Odense , Denmark
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