Prevalence of Upper Gastrointestinal Pathology in Patients with Obesity on Preoperative Endoscopy

Makiewicz, Kristine; Berbiglia, Lindsay; Douglas, Deborah; Bohon, Ashley; Zografakis, John G.; Dan, Adrian G.

doi:10.4293/jsls.2020.00021

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…The most common endoscopic pathology documented in this study was gastritis, found in 88 (80%) patients from either group; this observation is consistent with the results of previous studies [36]. Gastric polyps are often benign lesions, but may also be precursors for precancerous conditions and gastric cancer.…”

Section: Discussionsupporting

confidence: 92%

“…The prevalence of these pathologies did not differ significantly between the group with obesity and normal body weight. However, according to some authors [36], gastritis found during preoperative EGD may correlate with postoperative anastomotic ulceration. This implies that preoperative diagnosis and treatment of gastritis might contribute to better outcomes of bariatric treatment [37,38].…”

Section: Discussionmentioning

confidence: 95%

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Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Sierżantowicz

Ładny

Kurek

et al. 2021

JCM

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Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01–4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16–9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53–10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Sierżantowicz

Ładny

Kurek

et al. 2021

JCM

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“…[ 13 ] In a study done by Makiewicz et al . [ 14 ] UGIE showed hiatus hernia (23.5%), oesophagitis (9.5%), H. Pylori infection (7.1%), gastric erosions (5.7%), and duodenitis (3.7%).…”

Section: Discussionmentioning

confidence: 99%

Clinical and endoscopic study of dyspepsia in overweight and obese patients

Vaishnav

Basha

Sharma

et al. 2022

Journal of Family Medicine and Primary Care

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Objectives: Globally, the prevalence of obesity is increasing at an alarming rate. Obese patients often suffer from chronic dyspeptic symptoms. The aim of the study was to know the gross and histologic upper gastrointestinal mucosal changes and the prevalence of Helicobacter Pylori (H. Pylori) infection in overweight and obese dyspeptic patients. Materials and Methods: A cross-sectional, observational study was done on 100 patients with dyspepsia and a body mass index (BMI) of ≥25 kg/m 2 . The study was done between August 2019 and September 2021 at a tertiary care hospital in Maharashtra, India. Statistical Analysis: Chi-square test, Mann-Whitney test, and Fischer exact tests were applied to study the association between categorical variables. A P value of < 0.05 was considered statistically significant with a confidence level of 95%. Results: There were 59 males and 41 females. The mean age of the study subjects was 41.95 ± 12.32 years and the age range was 19–67 years. The maximum number of patients (36%) were in the age group of 50–59 years. Hypertension (45%) and type 2 diabetes mellitus (T2DM) (30%) were the common comorbidities present. Heartburn and regurgitation were the most common symptoms, present in 37% and 35% of the subjects, respectively. Inflammatory lesions oesophagitis (28%) and gastritis (43%) were the common findings in upper gastrointestinal endoscopy (UGIE). The stomach was the most common site with lesions. On histopathological examination, erosive gastritis (33%) and oesophagitis (28%) were confirmed. A total of 86% of obese subjects had at least one grossly abnormal finding. The prevalence of H. Pylori was 32%. Obese subjects had significantly more abnormal findings on UGIE compared to overweight subjects ( P < 0.05). Obese patients suffering from type 2 diabetes mellitus had significantly abnormal findings on UGIE compared to non-diabetic obese patients ( P < 0.05). Obese patients with higher body mass index (BMI) and the presence of H. Pylori infection were more likely to have abnormal UGIE findings. Conclusions: Inflammatory and erosive lesions of the stomach and oesophagus are more common in obese dyspeptic patients. UGIE should be the investigation of choice and should be performed in overweight and obese patients with dyspepsia to predict and prevent Gastrointestinal (GI) disorders and their related complications.

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“…The incidence of BE in the literature varies between 0.2 and 3,1% and reached 7,89% in GERD population [ 30 , 31 ]; GERD incidence ranges from 10 to 20% in the general population. In our study, the rate of BE was 0.3%, and that of GERD was 9.6%.…”

Section: Discussionmentioning

confidence: 99%

Indications for upper gastrointestinal endoscopy before bariatric surgery: a multicenter study

Abdallah

Skalli

Mcheimeche³

et al. 2022

Surg Endosc

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Background The role of preoperative upper gastrointestinal endoscopy before bariatric surgery is still debated, and a consensus among the international scientific community is lacking. The aims of this study, conducted in three different geographic areas, were to analyze data regarding the pathological endoscopic findings and report their impact on the decision-making process and surgical management, in terms of delay in surgical operation, modification of the intended bariatric procedure, or contraindication to surgery. Methods This is a multicenter cross-sectional study using data obtained from three prospective databases. The preoperative endoscopic reports, patient demographics, Body Mass Index, type of surgery, and Helicobacter pylori status were collected. Endoscopic findings were categorized into four groups: (1) normal endoscopy, (2) abnormal findings not requiring a change in the surgical approach, (3) clinically important lesions that required a change in surgical management or further investigations or therapy prior to surgery, and (4) findings that contraindicated surgery. Results Between 2006 and 2020, data on 643 patients were analyzed. In all of the enrolled bariatric institutions, preoperative endoscopy was performed routinely. A total of 76.2% patients had normal and/or abnormal findings that did not required a change in surgical management; in 23.8% cases a change or a delay in surgical approach occurred. Helicobacter pylori infection was detected in 15.2% patients. No patient had an endoscopic finding contraindicating surgery. Conclusions The role of preoperative UGE is to identify a wide range of pathological findings in patients with obesity that could influence the therapeutic approach, including the choice of the proper bariatric procedure. Considering the anatomical modifications, the incidence of asymptomatic pathologies, and the risk of malignancy, we support the decision of performing preoperative endoscopy for all patients eligible for bariatric operation. Graphical abstract

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Prevalence of Upper Gastrointestinal Pathology in Patients with Obesity on Preoperative Endoscopy

Cited by 8 publications

References 30 publications

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Clinical and endoscopic study of dyspepsia in overweight and obese patients

Indications for upper gastrointestinal endoscopy before bariatric surgery: a multicenter study

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