Endoscopic Evaluation of Patients Presenting with Heartburn
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 1
Abstract
Gastroesophageal reflux disease (GERD) is a common disorder affecting a large section of the community. In addition, the numerous complications of chronic GERD especially Barrett’s oesophagus necessitate adequate diagnosis and treatment of this common entity. This study was designed to analyze the spectrum of GERD based on presenting symptoms and endoscopic findings, and analyze the contributory factors. A prospective study was conducted on the patients visiting the medicine OPD at Department of Medicine, G.R. Medical College, Gwalior (M.P.) between July 2013 to November 2014 with symptoms suggestive of GERD. The clinical symptoms, possible risk factors and endoscopic findings were studied and analysed. A total of 100 patients were included in the study. The numbers of male patients (59%) was more than females. Most of the patients were in the age group 21-60 years (81%). The most common symptoms) other than heartburn (100%) were belching (89%), regurgitation (83%), abdominal pain (60%), vomiting (26%) and water brash (24%). History of smoking was present in 27% and alcohol consumption in 17%. BMI was <25 in 90% of the cases whereas on considering the waist to hip ratio (WHR), 31% were classified as obese. 52% of the patients had endoscopy positive lesions. 23% patients have esophagitis and 17% have gastritis 5% patients had hiatus hernia and 2% showed associated lesions like duodenitis/duodenal ulcers, 2% had sessile nodule and 2% had Barrett’s oesophagus out of them 1 patients had adenocarcinoma proven by histopathology. There were one patient each with oesophageal growth and oesophageal phlebectasia with candidiasis, diffuse esophageal spasm, upper esophageal obstruction. An unusual cause for heartburn was found which showed live worm in stomach. Symptomatic GERD may not be associated with endoscopic evidence of oesophagitis and reinforced the fact that NERD is a common entity, which forms a considerable proportion of patients seeking medical attention for reflux symptoms. However since the patients with Barret’s oesophagus are at a higher risk of developing adenocarcinoma, it is suggested that all patients with reflux symptoms should be subjected to UGI endoscopy and biopsy.
Authors and Affiliations
Arvind Chouhan, Amit Verma, Subhash Chandra, Jijo Verghese
Keywords
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