Document Detail


Prompt upper endoscopy is an appropriate initial management in uninvestigated chinese patients with typical reflux symptoms.
MedLine Citation:
PMID:  20354508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to investigate the prevalence of clinically significant endoscopic findings (CSEFs) in Chinese patients presenting with uninvestigated typical reflux symptoms in the absence of alarm symptoms, and to evaluate whether prompt endoscopy is an appropriate initial management in these patients.
METHODS: Consecutive patients presenting with uninvestigated typical reflux symptoms (i.e., heartburn or acid regurgitation) as chief complaints were recruited for symptom evaluation and upper endoscopy, followed by a 2-week proton pump inhibitor (PPI) therapy.
RESULTS: Of 469 patients recruited, CSEFs were observed in 180 (38.4%): 154 (32.8%) with erosive esophagitis (EE), 18 (3.8%) with Barrett's esophagus (BE), 24 (5.1%) with peptic ulcer disease (PUD), and 4 (0.9%) with carcinomas (1 esophageal carcinoma and 3 gastric adenocarcinomas). Multivariate analysis identified that an age >50 years (odds ratio (OR)=1.94, P=0.008), male gender (OR=4.11, P<0.001), being overweight or obese (OR=2.99, P<0.001), and alcohol use (OR=9.96, P<0.001) were independent risk factors for EE; an age >50 years (OR=4.61, P=0.003) and alcohol use (OR=5.50, P=0.003) were independent risk factors for BE; and Helicobacter pylori infection (OR=8.52, P<0.001) and alcohol use (OR=4.08, P=0.004) were independent risk factors for PUD. Symptom evaluation and response to PPI treatment were not correlated with EE, BE, and PUD in these patients.
CONCLUSIONS: CSEFs other than gastroesophageal reflux disease are present in a considerable proportion of Chinese patients with uninvestigated typical reflux symptoms but without alarm features. Symptom evaluation is of limited practical value, and thus prompt endoscopy seems to be an appropriate initial management option in these patients.
Authors:
Sui Peng; Li-Shou Xiong; Ying-Lian Xiao; Jin-Kun Lin; An-Jiang Wang; Ning Zhang; Pin-Jin Hu; Min-Hu Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-30
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2010-09-27     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1947-52     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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MeSH Terms
Descriptor/Qualifier:
Alcohol Drinking
Asian Continental Ancestry Group
Barrett Esophagus / complications,  diagnosis*
Endoscopy, Gastrointestinal
Esophagitis / complications,  diagnosis*
Female
Gastroesophageal Reflux / complications,  diagnosis,  therapy*
Helicobacter Infections / complications,  diagnosis*
Humans
Male
Multivariate Analysis
Odds Ratio
Overweight / complications
Peptic Ulcer / complications,  diagnosis*
Proton Pump Inhibitors / therapeutic use
Questionnaires
Risk Factors
Sex Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Proton Pump Inhibitors
Comments/Corrections
Comment In:
Am J Gastroenterol. 2011 Jun;106(6):1172-3; author reply 1173-4   [PMID:  21637277 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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