Clinical, endoscopic and histopathological correlation in gastro oesophageal reflux disease
Keywords:Acid peptic disease, Gastroesophageal reflux disease, Endoscopy, Heartburn
Background: Gastroesophageal reflux disease (GERD) is a common burden on health care resources in the Western world and deteriorates the health-related quality of life of those affected, but its manifestations in the general population are as yet unclear.
Methods: The present prospective study was conducted on 50 patients of acid peptic disease (APD) of both gender of age 15-75 were randomly selected. APD was diagnosed clinically in patients presenting the symptoms and were subjected to upper gastrointestinal (GI) endoscopy using Pentax FG29 gastroscope. The patients who had the classical symptoms of heart burn and reflux were diagnosed as GERD clinically and were examined for erosive changes by endoscopy.
Results: Out of the 16 patients diagnosed as GERD, majority of them 10 (62.5%) were vegetarian and 62.50% had symptoms from 3 to 12 months. 12 (75%) had visible erosions on endoscopy. The remaining 4 (25%) had normal endoscopic picture, the biopsy taken from whom showed inflammatory changes on histopathology.
Conclusions: The most common presenting complaint in patients of GERD was heartburn followed by regurgitation of gastric contents. Prevalence of GERD was found 32% in APD. In 12 (24%) of patients oesophagitis was seen on endoscopic examination. After medical treatment for 6-8 weeks, 37.5% of subjects become asymptomatic and 50% had partial symptomatic relief.
Allison PR, Johnstone AS. The oesophagus lined with gastric mucous membrane. Thorax. 1953;8(2):87-101.
Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis 1976;21(11):953-6.
Attwood SE, Smyrk TC, Demeester TR, Jones JB. Esophageal eosinophilia With dysphagia. A distinct clinicopathologic syndrome. Dig Dis Sci. 1993;38(1):109-16.
Barrett NR. Chronic peptic ulcer of the oesophagus and ‘oesophagitis’. Br J Surg. 1950;38(150):175-82.
Borch K, Jonsson KA, Petersson F, Redeen S, Mardh S, Franzen LE. Prevalence of gastroduodenitis and Helicobacter pylori infection in a general population sample: relations to symptomatology and life-style. Dig Dis Sci. 2000;45(7):1322-9.
Croese J, Fairley SK, Masson JW, Chong AK, Whitaker DA, Kanowski PA, et al. Clinical and endoscopic features of eosinophilic esophagitis in adults. Gastrointest Endosc. 2003;58(4):5.
Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54(5):710-7.
Dent J. Definitions of reflux disease and its separationfrom dyspepsia. Gut. 2002;50(4):17-20.
Dent J. Gastro-oesophageal reflux disease. Digestion. 1998;59(5):433-45.
Falk GW. Barrett's esophagus. Gastroenterology. 2002;122(6):1569-91.
Thrift AP, Kramer JR, Qureshi Z, Richardson PA, El-Serag HB. Age at Onset of GERD Symptoms Predicts Risk of Barrett’s Esophagus. Am J Gastroenterol. 2013;108(6):915-22.
Yang SY, Lee OY, Kim HE, Chang YK, Yoon BC, Choi HS. Relationship Between Gastroesophageal Reflux Symptoms and Dietary Factors in Korea. J Neurogastroenterol Motil. 2011;17(1).
Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102:1259-68.
El-Serag HB, Petersen NJ, Carter J. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;126:1692-9.
Mohammed I, Nightingale P, Trudgill NJ. Risk factors for gastrooesophageal reflux disease symptoms: a community study. Aliment Pharmacol Ther. 2005;21:821-7.
Hollenz M, Stolte M, Labenz J. Prevalence of gastro-oesophageal reflux disease in general practice. Dtsch Med Wochenschr. 2002;127(19):1007-12.
Klauser AG, Schindlbeck NE, Miiller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990;335(8683):205-8.
Locke GR, Talley NJ, Fett SL, Zinsmeister AR, Melton TO LJ. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;112:1448-56.
Zagari M, Villa KP, Freston JW. Proton pump inhibitors versus H2- receptor antagonists for the treatment of erosive gastroesophageal reflux disease: a cost-cooperative study. Am J Managed Care. 1995;1:247-55.