Original Research

Endoscopic Observation Around the Gastroesophageal Junction in Patients with Symptomatic Reflux Disease

Muhammad Usama
Department of Medicine, Services Institute of Medical Sciences, Lahore
Muhammad Naeem Afzal
Department of Medicine, Services Institute of Medical Sciences, Lahore
Tabish Raza
Department of Medicine, Services Institute of Medical Sciences, Lahore
Muhammad Arif Nadeem
Department of Medicine, Services Institute of Medical Sciences, Lahore

✉ Correspondence: Muhammad Arif Nadeem Email: arifnadeem1234@gmail.com

DOI https://doi.org/10.70302/jpsim.v1i1.2012
Volume: 1, Issue 1 Pages: 50–54 Published: 16 Dec 2020
Received: 14 Sep 2020 Accepted: 14 Oct 2020 Published Online: 16 Dec 2020

Abstract

Objectives

The study was done to determine the endoscopic findings around the gastro esophageal junction in patient with symptomatic reflux disease.

Methods

This was a Cross sectional study, conducted in Gastroenterology Ward (M-III), Services Hospital Lahore from 15-03-2016 to 14-09-2017. Two hundred and fifty patients were enrolled in the study. Demographic data was collected from each patient. Patients were evaluated for the presence of various abnormalities on endoscopy (i.e., RE, HH and CLE). All data was collected through a predefined proforma. Data was analyzed through SPSS version 21.

Results

Mean age of patients was 34.40+3.78. Most of the patients (54%) were between the ages of 31-50 years. Majority of the patient were male. Endoscopic findings in the patients of gastroesophageal reflux disease (GERD) include reflux esophagitis (RE), hiatus hernia (HH) and columnar lined esophagitis (CLE) with prevalence of 11.9%, 16.2% and 10% respectively. A total of 62% patients have normal endoscopy. There was no significant relationship between age, sex, duration of GERD, presence of DM and HTN with endoscopic findings.

Conclusion

Majority of the patients with clinical GERD have normal endoscopic findings and other findings include RE, HH and CLE with prevalence of 11.9%, 16.2% and 10%.

Keywords
GERD Endoscopy Hiatus Hernia

How to Cite This Article

Usama M, Afzal MN, Raza T, Nadeem MA. Endoscopic Observation Around the Gastroesophageal Junction in Patients with Symptomatic Reflux Disease. J Pak Soc Intern Med. 2020;1(1):50–54. doi:10.70302/jpsim.v1i1.2012

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. . El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2014; 63(6):871-80.
  2. Jung H-K. Epidemiology of gastroesophageal reflux disease in Asia: a systematic review. J Neurogastroenterol Motil. 2011; 17(1):14.
  3. Shiwani MH. Short Communication-Treatment of Gastroesophageal Reflux Disease: A call for increase awareness and local research. J Pak Med Assoc 2011; 61(3):283.
  4. Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche J, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterol 2012; 111(1):85-92.
  5. Wright RA, Hurwitz AL. Relationship of hiatal hernia to endoscopy proven esophagitis. Dig Dis Sci 1979; 24(4): 311–3.
  6. Boyce HW. Endoscopic definitions of esophagogastric junction regional anatomy. Gastrointest Endos. 2011; 51(5):586-92.
  7. Navarathne NMM, Abeysuriya V, Ileperuma A, Thoufeek UL. Endoscopic observations around the gastroesophageal junction in patients with symptomatic gastroesophageal reflux disease in South Asia. Indian J Gastroenterol. 2010; 29(5):184
  8. Boyce HW. Endoscopic definitions of esophagogastric junction regional anatomy. Gastrointest Endos. 2011; 51(5):586-92.
  9. Kim JH, Hwang JK, Kim J, Lee SD, Lee BJ, Kim JS, Bak YT. Endoscopic findings around the gastroesophageal junction: an experience from a tertiary hospital in Korea. Korean J Intern Med. 2008; 23(3):127-33.
  10. Furukawa N, Iwakiri R, Koyama T, et al. Proportion of reflux esophagitis in 6010 Japanese adults: prospective evaluation by endoscopy. J Gastroenterol 1999; 34(4): 441–4.
  11. Yeom SJ, Park HJ, Cho JS, Lee SI, Park IS. Reflux esophagitis and its relationship to hiatal hernia. Korean J Med Sci 1999; 14(3): 253–6.
  12. Kim GH, Kang DH, Song GA, Kim TO, Heo J, Cho M, Kim JS, Lee BJ, Wang SG. Gastroesophageal flap valve is associated with gastroesophageal and gastropharyngeal reflux. J Gastroenterol. 2006; 41(7):654–61.
  13. Lee JY, Hong WK, Sohn KM, Kim DY, Kim YM, Choi HH, Choi CS, Kim SJ, Baek KH, Kim JB, Kim DJ. Prevalence and clinical characteristics of gastroesophageal reflux disease and reflux esophagitis in Chuncheon city: health care examination study. Korean J Med. 2008; 74(4):385–90.
  14. Goh KL. Changing epidemiology of gastroesophageal reflux disease in the Asian-Pacific region: an overview. J Gastroenterol Hepatol. 2004; 19(Suppl 3): S22–5.
  15. Ho KY, Chan YH, Kang JY. Increasing trend of reflux esophagitis and decreasing trend of Helicobacter pylori infection in patients from a multiethnic Asian country. Am J Gastroenterol. 2005; 100(9):1923–8.
  16. Wong BC, Kinoshita Y. Systemic review on epidemiology of gastroesophageal reflux disease in Asia. Clin Gastroenterol Hepatol. 2006; 4(4):398–407.
  17. Gado A, Ebeid B, Abdel Mohsen A, Axon A. Prevalence of reflux esophagitis among patients undergoing endoscopy in a secondary referral hospital in Giza, Egypt. Alexandria Journal of Medicine 2015; 51(2):89-94
  18. Kim GH. Columnar-lined Esophagus: Its Prevalence and Predictors in Patients with Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2013; 19(2):261–263.
  19. Balasubramanian G, Singh M, Gupta N, Gaddam S, Giacchino M, Wani SB, et al. Prevalence and predictors of columnar lined esophagus in gastroesophageal reflux disease (GERD) patients undergoing upper endoscopy. Am J Gastroenterol. 2012; 107(11):1655-61.
  20. Spechler SJ, Zeroogian JM, Antonioli DA, Wang HH and Goyal RK. Prevalence of metaplasia at the gastro-oesophageal junction. Lancet 1994; 344(8936): 1533-6.
  21. Wallner B, Sylvan A, Stenling R and Janunger KG. The Z-line appearance and prevalence of intestinal metaplasia among patients without symptoms or endoscopical signs indicating gastroesophageal reflux. Surg Endosc 2001; 15(8): 886-9.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2020 Journal of Pakistan Society of Internal Medicine.
📃 In This Issue View All
Original Article Impact of Diabetes Mellitus on Post-Operative Wound Healing in General Surgery Siddiqui FA, Noor M, Akhtar W Review Article Statin Therapy in Non-Alcoholic Fatty Liver Disease: A Systematic Review Nawaz F, Cheema HA, Mehmood Y Original Article Outcomes of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Retrospective Analysis Raza SH, Butt N, Qureshi AM Original Article Serum Ferritin as a Prognostic Marker in COVID-19 Severity: A Hospital-Based Study Rehman N, Sheikh I, Javed K Review Article Antibiotic Resistance Patterns in Community-Acquired Pneumonia: Emerging Trends Hussain I, Farooq Z
👥 More by These Authors
Original Article Prevalence of Hypertension Among Urban Adults in Pakistan: A Cross-Sectional Study Khan TM, Ahmed S, Malik RA Original Article Cervical Cancer Screening Awareness Among Rural Women in Punjab Bibi S, Anjum R, Hassan F Review Article Thyroid Disorders in Pregnancy: Clinical Implications and Management Strategies Baig BI, Usman A Original Article Neonatal Sepsis: Bacteriological Profile and Antibiogram in a Tertiary Care Hospital Iqbal M, Rashid T
🔗 Related Articles By Keywords
Original Article Outcomes of Laparoscopic Cholecystectomy in Acute Cholecystitis: A Retrospective Analysis Raza SH, Butt N, Qureshi AM Original Article Serum Ferritin as a Prognostic Marker in COVID-19 Severity: A Hospital-Based Study Rehman N, Sheikh I, Javed K Review Article Antibiotic Resistance Patterns in Community-Acquired Pneumonia: Emerging Trends Hussain I, Farooq Z Original Article Comparison of Ultrasound-Guided versus Landmark-Based Central Venous Catheter Insertion Zafar S, Gillani SA