Alireza Sharifi, Shahab Dolatshahi , Atefeh Rezaeifar , Tayeb Ramim ,
Volume 72, Issue 6 (9-2014)
Abstract
Background: Lack of precise diagnostic criteria and sufficient findings in support of biopsy sampling during upper gastrointestinal endoscopy is one of the special challenge in endoscopy assessment in Barrett's esophagus. The aim of this study was to evaluate the mucosa in the distal esophagus tissues through a biopsy during upper gastrointesti- nal endoscopy in gastroesophogeal reflux disease patients whose symptoms don't im- prove or only partially resolve with treatment.
Methods: A cross-sectional study was done in patients with gastroesophogeal reflux disease medically resistant to treatment. The patients were assessed by gastroenterology department in Sina Hospital, Tehran, Iran, since September 2012 to September 2013. Patients with coagulopathy, esophageal varicose, esophageal cancer, earlier detection of developing Barrett's esophagus, history of irritable bowel syndrome, psychological dis- orders and using of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, were excluded. Esophageal squamous epithelium and cylindrical tissue of stomach was carefully checked by endoscope. Then 2 to 4 biopsy of the Z-line above the gastroe- sophageal mucosa were obtained.
Results: One hundred and fifty three patients included 78 men (51%) and 75 females (49%) with a mean age of 47.92±17.57 years participated in the study. The mean of body mass index of patients was 25.05±4.17 kg/m2 and body mass index in 45.8 % of the patients more than 230 kg/m2. Biopsy specimens were taken in 31 cases were not enough for histological examination. In other patients, 25 cases (20.5%) were normal and 97 cases (79.5%) had the following pathological diagnosis: mild esophagitis (49 cases 40.2%), moderate esophagitis (24 cases 19.7%), severe esophagitis (14 cases
11.5%), Barrett's esophagus (8 cases, 6.5%), fungal esophagitis (1 cases, 0.8%), and eosinophilic esophagitis (1 cases 0.8%). 117 patients (76.5%) had H. pylori infection. Sensitivity and specifity of endoscopy for detection of Barrett's esophagus during upper gastrointestinal endoscopy were 100% and 84.13% (CI 95%:78.53-89.09%), respec- tively.
Conclusion: Our data showed that doing of accurate and adequate biopsy samples from lesions in upper GI endoscopy can be helpful in the diagnosis of Barrett's esophagus
Raika Jamali, Reza Zamani, Tayeb Ramim,
Volume 79, Issue 5 (8-2021)
Abstract
Background: Inlet patch (IP) lesion is the presence of gastric columnar epithelial tissue outside of the stomach. Symptoms such as a lump in the throat, chronic cough, laryngitis, or other mouth-throat symptoms may be IP-related only and have no other abnormalities. This study aimed to determine the relationship between globus sensation and structural disorder of Inlet Patch in patients with gastroesophageal reflux disease
Methods: The case-control study was performed in patients who were referred to the endoscopy ward of Sina Hospital in Tehran from October 2016 to October 2017. Inclusion criteria were diagnosis of gastroesophageal reflux and endoscopic indications. Patients who had endoscopic indications and underwent endoscopy were evaluated. Information on reflux esophagitis and inlet patch structural disorder were determined. Symptoms of reflux, including a lump in the throat, were identified and recorded. Then the frequency of globus sensation in patients with inlet patch structural disorder (patient group) and without it (control group) was compared.
Results: A total of 100 patients with gastric reflux participated in this study. Patients included 42 men (42%) and 58 women (58%). The mean age of patients was 41.17±10.35 years (18-77 years). The severity of mild reflux was 57%, moderate reflux was 27% and severe reflux was 16%. 28% of patients had a lump in the throat and 12 patients had an inlet patch. There was a statistically significant relationship between inlet patch and globus sensation (p=0.001). All patients with inlet patch had globus sensation. 81.8% of patients without inlet patch did not feel a lump in the throat. The results showed a statistically significant difference between the two groups with and without inlet patch in terms of globus sensation in general and in terms of different clinical variables (p=0.001).
Conclusion: The findings of the study showed that inlet patch had a significant relationship with the feeling of a lump in the throat and all patients with inlet patch felt Globus sensation.As the result, to diagnose a patient with an inlet patch, other causes such as esophagitis, hernia, heartburn and metabolic syndrome should be ruled out.
