Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1, Nabeshima, Saga 849-8501, Japan.
J Clin Biochem Nutr. 2010 May;46(3):229-33. doi: 10.3164/jcbn.09-96. Epub 2010 Apr 10.
The clinical features of patients reflux esophagitis without any symptoms have not been clearly demonstrated. This study evaluated the clinical features of patients with endoscopy-positive reflux esophagitis, who did not complain of symptoms, as detected by brief questioning by nursing staffs. Eight thousand and thirty-one patients not taking medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia and acid regurgitation by nursing staffs before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) patients were classified as positive for reflux esophagitis. The endoscope positive subjects who complain heartburn were 539/1199 (45.0%).The endoscope positive subjects who do not complain symptoms were 465 in 1199 positive reflux esophagitis (38.8%). We compared endoscopic positive subjects without any complain by brief question by nursing staffs to endoscopic positive subjects with heartburn. Male gender, no obesity, absence of hiatus hernia, and low-grade esophagitis were associated with endoscopy-positive patients who do not complain of symptoms. The results of this study indicated correct detection of clinical symptoms of reflux esophagitis might be not easy with brief questioning by nursing staffs before endoscopic examination.
患者无任何症状的反流性食管炎的临床特征尚未明确。本研究通过护理人员简短询问,评估了内镜阳性但无症状的反流性食管炎患者的临床特征。在进行内镜检查评估洛杉矶分类的食管炎之前,8031 名未服用胃肠道疾病药物的患者,由护理人员简要询问是否存在烧心、吞咽困难、咽喉痛和胃酸反流。内镜检查发现 1199 例(14.9%)患者存在反流性食管炎。1199 例内镜阳性患者中,有 539 例(45.0%)主诉烧心。在 1199 例内镜阳性的反流性食管炎患者中,有 465 例(38.8%)无症状。我们将护理人员简短询问后无症状的内镜阳性患者与有烧心症状的内镜阳性患者进行了比较。男性、非肥胖、无食管裂孔疝和轻度食管炎与无症状的内镜阳性患者相关。本研究结果表明,内镜检查前护理人员简短询问可能不易正确发现反流性食管炎的临床症状。