Low yield of endoscopy in patients with persistent dyspepsia taking proton pump inhibitors

Smith, Taylor E.; Verzola, Edwardo; Mertz, Howard

doi:10.1067/mge.2003.308

Cited by 13 publications

(12 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our data show that referral for empirical−treatment failure does not increase the probability of finding an organic abnormality. These results are supported by Smith et al [13], who showed that the endoscopic yield in pa− tients who fail to respond to empirical treatment is significantly lower than it is in patients who showed an excellent response to PPI therapy. Furthermore, the finding that referral for alarm symptoms does not substantially contribute to finding an organ− ic abnormality (although statistically significant) is concordant with the findings of Wallace et al [10], who concluded that age and the presence of "high−risk" symptoms were both poor pre− dictors of major endoscopic lesions in their study of a very large number of patients with dyspepsia.…”

supporting

confidence: 80%

Is there any association between referral indications for open-access upper gastrointestinal endoscopy and endoscopic findings?

Kerkhoven¹,

Rijswijck²,

Rossum³

et al. 2007

Endoscopy

View full text Add to dashboard Cite

show abstract

supporting

confidence: 80%

Is there any association between referral indications for open-access upper gastrointestinal endoscopy and endoscopic findings?

Kerkhoven¹,

Rijswijck²,

Rossum³

et al. 2007

Endoscopy

View full text Add to dashboard Cite

show abstract

“…So, many of the esophagitis observed should be considered refractory cases not responding to PPI. It has been suggested that the interruption of PPI for some weeks before endoscopy may improve its diagnostic sensitivity, 16,27 but this affirmation remains largely unproven.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Finally, the role of drugs in the pathogenesis of severe esophagitis is especially controversial and has been only partially evaluated. While the use of PPIs is considered to be a protective factor, 11,16 the role of other drugs such as anticholinergics, 17 nitrates 11,18 and tricyclic antidepressants, calcium antagonists or sulcralfate 11 is more debatable. In particular, the results of studies of the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) have been contradictory.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of severe esophagitis in Spain. Results of the PRESS study (Prevalence and Risk factors for Esophagitis in Spain: A cross‐sectional study)

et al. 2016

View full text Add to dashboard Cite

Background: The current prevalence of esophagitis in southern Europe is unknown. In addition, the risk factors for reflux esophagitis are not fully understood. Objective: The objective of this article is to assess the prevalence and risk factors for esophagitis in Spain. Methods: A prospective, observational, cross-sectional, multicenter study (PRESS study) was conducted among 31 gastrointestinal endoscopy units throughout Spain. A total of 1361 patients undergoing upper gastrointestinal endoscopy were enrolled. Sociodemographic, clinical and treatment data were recorded. Results: A total of 95% of patients were Caucasian and 52% were male (mean age: 53 AE 17 years). The most frequent symptoms prompting endoscopy were heartburn (40%), regurgitation (26%) and dysphagia (15%). Fifty-four percent of patients undergoing endoscopy were receiving proton pump inhibitor (PPI) treatment. Esophagitis (mainly mild-moderate) was present in 154 (12.4%) patients. The severe form was recorded in only 11 (0.8%) patients. Multivariate analysis results indicated that the likelihood of esophagitis was higher in men (OR ¼ 1.91, 95% CI ¼ 1.31-2.78), in patients with high GERD-Q scores (OR ¼ 1.256, 95% CI ¼ 1.176-1.343), weight increase (OR ¼ 1.014, 95% CI ¼ 1.003-1.025) and high alcohol consumption (OR ¼ 2.49, 95% CI ¼ 1. 16-5.36). Conclusion: Severe esophagitis is a rare finding in the Spanish population. Male gender, high GERD-Q score, weight increase and high alcohol consumption are main risk factors for its appearance.

show abstract

“…Empirical treatment of heartburn before endoscopy is currently the rule and it is well known that the prevalence of endoscopic findings is sharply reduced by previous antisecretory treatment [19]. It would be interesting to determine whether the diagnosis of severe esophagitis remains frequent under the current conditions of widespread PPI use.…”

Section: Introductionmentioning

confidence: 99%

Esophagitis in a High H. pylori Prevalence Area: Severe Disease Is Rare but Concomitant Peptic Ulcer Is Frequent

et al. 2011

View full text Add to dashboard Cite

BackgroundFew data are available on the prevalence of erosive and severe esophagitis in Western countries.ObjectiveTo retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain.DesignRetrospective observational study. A multivariate analysis was performed to determine variables predicting severe esophagitis.SettingDatabases of 29 Spanish endoscopy units.PatientsPatients submitted to a diagnostic endoscopy during the year 2005.InterventionsRetrospective review of the databases.Main Outcome MeasurementsEsophagitis severity (graded according to the Los Angeles classification) and associated endoscopic findings.ResultsEsophagitis was observed in 8.7% of the 93,699 endoscopies reviewed. Severe esophagitis (LA grade C or D) accounted for 22.5% of cases of the disease and was found in 1.9% of all endoscopies. Incidences of esophagitis and those of severe esophagitis were 86.2 and 18.7 cases per 100,000 inhabitants per year respectively. Male sex (OR 1.89) and advanced age (OR 4.2 for patients in the fourth age quartile) were the only variables associated with severe esophagitis. Associated peptic ulcer was present in 8.8% of cases.LimitationsRetrospective study, no data on individual proton pump inhibitors use.ConclusionsSevere esophagitis is an infrequent finding in Spain. It occurs predominantly in males and in older individuals. Peptic ulcer disease is frequently associated with erosive esophagitis.

show abstract

Low yield of endoscopy in patients with persistent dyspepsia taking proton pump inhibitors

Cited by 13 publications

References 29 publications

Is there any association between referral indications for open-access upper gastrointestinal endoscopy and endoscopic findings?

Is there any association between referral indications for open-access upper gastrointestinal endoscopy and endoscopic findings?

Prevalence of severe esophagitis in Spain. Results of the PRESS study (Prevalence and Risk factors for Esophagitis in Spain: A cross‐sectional study)

Esophagitis in a High H. pylori Prevalence Area: Severe Disease Is Rare but Concomitant Peptic Ulcer Is Frequent

Contact Info

Product

Resources

About