Esophageal disorders in the etiology and pathophysiology of dyspepsia

Wienbeck, M; Berges, W

doi:10.3109/00365528509103947

Cited by 19 publications

(11 citation statements)

References 14 publications

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“…Many patients with a normal examination will probably have symptomatic gastrooesophageal reflux without evidence at endoscopy. Al though heartburn is considered the leading symptom in gastrooesophageal reflux disease [62,[64][65][66], we found that also patients with gastritis and those with duodenitis/ bulbitis experienced heartburn more often than patients having a normal endoscopy. In a study by Johnsen et al…”

Section: Discussionmentioning

confidence: 63%

The Discriminative Value of Patient Characteristics and Dyspeptic Symptoms for Upper Gastrointestinal Endoscopic Findings: A Study on the Clinical Presentation of 1,147 Patients

Adang

Ambergen²,

Talmon³

et al. 1996

Digestion

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The discriminative value of patient characteristics and dyspeptic symptoms for upper gastrointestinal endoscopic findings was prospectively assessed in 1,147 patients attending for their first diagnostic endoscopy and who answered paper (n = 431) or computerized (n = 716) questionnaires. The questionnaires provided detailed information concerning present dyspeptic symptoms, with special attention to provoking and/or relieving factors, and smoking and/or drinking habits. In logistic regression models each of a number of ‘specific endoscopic diagnoses’ was contrasted with normal endoscopy (n = 390), and ‘relevant endoscopic disease’ (oesophagitis, peptic ulcers, cancers; n = 269) was contrasted with ‘irrelevant’ and normal endoscopic findings (n = 878). From the regression model a receiver operating characteristic (ROC) curve could be constructed, and the area under the ROC curve (AUC) was calculated to summarize the discriminative power of the regression model. The best discrimination from patients with a normal endoscopy was achieved for patients with gastric (AUC = 0.86) or duodenal (AUC = 0.85) ulcers, followed by patients with hiatus hernia (AUC = 0.78) or oesophagitis (AUC = 0.77). The discriminative performance of the regression models was somewhat less for duodenitis/bulbitis (AUC = 0.75) and endoscopic gastritis (AUC = 0.73). In an open-access endoscopy unit setting, the value of preinves-tigation history-taking for the prediction of clinically relevant endoscopic disease was very limited (AUC = 0.63).

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Section: Discussionmentioning

confidence: 63%

The Discriminative Value of Patient Characteristics and Dyspeptic Symptoms for Upper Gastrointestinal Endoscopic Findings: A Study on the Clinical Presentation of 1,147 Patients

Adang

Ambergen²,

Talmon³

et al. 1996

Digestion

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“…The symptoms of gastro-oesophageal reflux disease are not always typical, and several methods have been evolved for detecting the presence of this condition (3,8,10,16,20,32,33,36). Despite various attempts to improve the radiographic technique it has been deemed unreliable for detecting reflux.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of gastro-oesophageal reflux disease is not precisely known, but the condition is not uncommon (2,24,30,36). Oesophagitis produced by reflux can lead to serious complications, such as stricture and epithelial metaplasia-Barrett's oesophagus-with some risk of malignancy (7,10,23).…”

mentioning

confidence: 99%

Radiologic Diagnosis of Gastro-Oesophageal Reflux

Fransson¹,

Sökjer²,

Johansson³

et al. 1989

Acta Radiol

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In 149patients, a standardized radiologic method for the detection of gastro-oesophageal reflux was applied and compared with the results obtained at endoscopy and by a manometric reflux test. Radiologic reflux was recorded in 53 patients, of whom 25 had reflux without abdominal compression and 51 with compression. At least one of the other two types of examination disclosed pathologic conditions in all but 2 of 53 patients. Oesophagitis was significantly more severe among the patients with reflux observed at radiography. The presence of hiatal incompetence with reflux only to the hiatal hernia but not to the oesophagus was not a strong indicator of gastro-oesophageal reflux disease. Hiatal hernia was present in a significantly larger number of the patients with reflux at radiography than in those without reflux. Increased width of the hiatus gave stronger evidence for reflux disease than in patients with a normal hiatus. Thus, the width of the hiatus also had a bearing on the diagnosis of gastro-oesophageal reflux disease.

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“…When asking reflux patients with heartburn to distinguish between the symptom most bothersome to them and other accompanying symptoms, more than a third also had symptoms in the upper abdomen such as epigastric pain, nausea and vomiting ie symptoms of dyspepsia. More than half had several symptoms of equal severity and it was not possible to establish a dominant symptom (68). In another study, a group of patients with normal reflux by 24h pH-metry had more reflux related symptoms and presumed esophageal hypersensitivity.…”

Section: Gastroesophageal Reflux-like Dyspepsiamentioning

confidence: 94%

Definitions of Dyspepsia: Time for a Reappraisal

Chiba¹

1998

The European Journal of Surgery

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While many definitions exist, dyspepsia is best considered a symptom complex (not a diagnosis) thought to arise in the upper gastrointestinal tract, unrelated to defecation. The symptom complex includes: upper abdominal/ epigastric pain or discomfort, postprandial fullness, bloating, belching, early satiety, anorexia, nausea, retching, vomiting, heartburn and regurgitation. Patients with typical gastroesophageal reflux, biliary colic and irritable bowel syndrome should not be considered to have dyspepsia. After investigations, if a cause of dyspepsia is found, this is 'organic or structural' dyspepsia. If no structural cause is found, this is best called 'functional dyspepsia', subclassified into a) ulcer-like b) dysmotility-like c) reflux-like and d) unspecified dyspepsia. This symptom guided classification should be shifted to the first presentation with uninvestigated dyspepsia, prior to any investigations, to define a clinically useful guide to patient care. As there is considerable symptom overlap, it may be useful to combine together the ulcer and reflux-like groups into an acid-related dyspepsia group. In 1998, another approach would be to screen dyspeptic patients with an H. pylori test and classify them as H. pylori positive and negative dyspepsia.

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Esophageal disorders in the etiology and pathophysiology of dyspepsia

Cited by 19 publications

References 14 publications

The Discriminative Value of Patient Characteristics and Dyspeptic Symptoms for Upper Gastrointestinal Endoscopic Findings: A Study on the Clinical Presentation of 1,147 Patients

The Discriminative Value of Patient Characteristics and Dyspeptic Symptoms for Upper Gastrointestinal Endoscopic Findings: A Study on the Clinical Presentation of 1,147 Patients

Radiologic Diagnosis of Gastro-Oesophageal Reflux

Definitions of Dyspepsia: Time for a Reappraisal

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