The importance of upper gastrointestinal endoscopy in morbidly obese patients

Baysal, Birol; Kayar, Yusuf; Danalıoğlu, Ahmet; Özkan, Tuba; Kayar, Nuket Bayram; Ünver, Nurcan; Bozkurt, Süleyman; İnce, Ali Tüzün

doi:10.5152/tjg.2015.0083

Cited by 9 publications

(7 citation statements)

References 20 publications

(20 reference statements)

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“…In a study by Baysal et al . [ 11 ] high BMI and H. Pylori infection were significantly associated with abnormal UGIE, which was similar to current findings. However, advancing age was also associated with abnormal endoscopy, which was in contrast to the current findings.…”

Section: Discussionsupporting

confidence: 91%

“…In a similar study conducted by Baysal et al . [ 11 ] in 127 patients, diabetes mellitus was seen in 36.2% of patients, hypertension in 35.4%, dyslipidaemia in 36.2%, asthma in 5.5%, and IHD in 1.5%. They divided the cases into Group I-those having normal UGIE ( n = 25 (19.6%)) and those having abnormal UGIE ( n = 102 (80.4%)).…”

Section: Discussionmentioning

confidence: 99%

“…In a few other studies, the prevalence of H. Pylori infection in obese patients was more than 35% (44.9% and 37.5%, respectively). [ 11 21 ]…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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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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“…[5] Patients with obesity are known to have higher risk o f u p p e r g a s t r o i n t e s t i n a l ( U G I ) p a t h o l o g y. Esophago-gastro-duodenoscopy (OGD) is considered the investigation of choice to detect and confirm UGI pathology in a patient with obesity. [6] Some practitioners recommend routine OGD before all bariatric surgery, while others insist particularly on preoperative OGD before gastric bypass. As in LRYGB surgery, the remnant large pouch of the stomach is completely closed off with no further access to it in the future.…”

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confidence: 99%

Pathology pick up rate in routine preoperative endoscopy and its impact on patients undergoing gastric bypass surgery

Bakhshi

Ishak

Rankin³

et al. 2022

Libyan J Med Sci

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IntroductIonThe epidemic of obesity (having a body mass index [BMI] of 30 and above) and its related medical diseases has been recognized as one of the most common public health problems facing the world today. [1] According to the World Health Organization, around 2 billion adults (40%) are classified as overweight, of those 650 million (13% of the total population) are diagnosed with obesity worldwide in 2016. [1] Scotland is one of the most significantly affected countries. In 2018, the majority of adults in Scotland (65%) was overweight, around one-third of those were diagnosed with obesity (28%). [2] Among treatment modalities for obesity, bariatric surgery has been the most effective intervention for sustained weight loss. Bariatric surgery ameliorates obesity concurrent metabolic syndrome in the majority of patients. [3] Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is one of the bariatric procedures where restriction and malabsorption of food happen simultaneously. [4] Adequate preoperative workup is essential for the success of bariatric surgery. This workup is not only restricted to exercise, preoperative weight loss or attending a teaching program, but Background and Aims: Patients with obesity are known for higher chances of having upper gastrointestinal (UGI) pathology and diseases. Esophagogastroduodenoscopy (OGD) is considered the investigation of choice to detect and confirm UGI pathology in patient with obesity. The routine OGD as a preoperative workup remained controversial before gastric bypass surgery. The need for preoperative OGD on patients undergoing bariatric surgery has been a subject of debate among bariatric surgeons. The study's aim is to evaluate the impact of routine preoperative endoscopy on patients underwent gastric bypass surgery laparoscopic Roux-en-Y gastric bypass (LRYGB). Patients and Materials: Retrospective review of prospectively kept patients' records who underwent LRYGB in our unit from February 2009 to March 2020. Patients were divided into two groups according to the absence or presence of symptoms before their preoperative OGD: Group A (asymptomatic patients) and Group B (symptomatic patients). Further data on OGD reports, campylobacter-like organism test and histology results and changes in the management plan were collected and analyzed. Calculation of post hoc power and Fisher's exact test was to investigate the correlation between OGD indication and its findings. All analyses were conducted at a 5% critical level. Results: A total of 114 patients included in the analysis, 85 (74.56%) were in Group A and 29 in Group B. OGD detected pathology in 34 patients in Group A and 21 in Group B (P = 0.004). Those included hiatus hernia (HH) (17.65% Group A, 44.83% Group B, P = 0.006); stomach ulcer (7.06% Group A, 3.45% Group B, P = 0.676), Helicobacter pylori (H. pylori) infection (12.86% Group A, 29.41% Group B). This led to change of management in 22 patients in Group A and 12 in Group B (P = 0.157). Those changes included H. pylori eradication (10.59% Group A,...

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“…To the Editor, We read with great interest a paper in a recent issue written by Baysal et al (1) implicating the importance of upper gastrointestinal endoscopy in morbidly obese patients who were hospitalized for bariatric surgery. This study provides us with important data regarding the gastrointestinal problems of obese patients, and authors advise routine upper gastrointestinal endoscopy to all morbidly obese patients.…”

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confidence: 99%