Sahin Mestan, Akbulut Canan, Dolapcioglu Can, Ozpolat Eyup, Dabak Resat, Aliustaoglu Mehmet, Ahishali Emel
Department of Internal Medicine, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
Department of Family Medicine, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2015 Jan 24;1(3):158-165. doi: 10.14744/nci.2014.54227. eCollection 2014.
To evaluate the endoscopic findings of dyspeptic patients unresponsive to proton pump inhibitors (PPIs) and analyze if there is any correlation between these findings and dyspeptic symptoms via predetermined inquiry.
Patients between 18 and 45 years of age were selected among those referred to our unit for upper GI endoscopy due to failure to achieve improvement in dyspeptic complaints with PPI. Patients who consent to participate in and eligible for the study were questioned for their symptoms using questionnaires.
A total of 446 patients with female preponderance (60%) were included in the study. Endoscopic results were listed as: 147 (32.9%) normal, 16 (3.6%) gastric ulcer, 36 (8.1%) duodenal ulcer, 216 (48.4%) gastritis, 7 (1.5%) duodenitis and 24 (5.4%) esophagitis. A total of 122 patients were classified as functional dyspepsia. While incidence of persistent bloating was distinctly higher in patients with gastritis compared to those with normal endoscopic findings (p:0.000), but its incidence was comparable between ulcer and normal patients. No statistical difference was detected between gastritis, ulcer and normal endoscopy patients considering incidence of early satiety. Compared to those with normal endoscopy patients, incidence of epigastric pain was significantly higher among patients with gastritis and ulcer (p: 0.002 and p: 0.000 respectively). Incidence of heartburn was higher in patients with gastritis compared to those with normal endoscopy findings, but it was similar to those with ulcer.
Most (67.1%) of the patients between 18 and 45 years of age with no alarm symptoms had diagnoses that required use of a PPI. Hence, the patients should be carefully evaluated before referring for endoscopy.
评估对质子泵抑制剂（PPI）无反应的消化不良患者的内镜检查结果，并通过预先设定的询问分析这些结果与消化不良症状之间是否存在相关性。
从因使用PPI后消化不良症状未改善而转诊至我院进行上消化道内镜检查的患者中，选取年龄在18至45岁之间的患者。同意参与并符合研究条件的患者通过问卷询问其症状。
共有446例患者纳入研究，其中女性占多数（60%）。内镜检查结果如下：147例（32.9%）正常，16例（3.6%）胃溃疡，36例（8.1%）十二指肠溃疡，216例（48.4%）胃炎，7例（1.5%）十二指肠炎，24例（5.4%）食管炎。共有122例患者被归类为功能性消化不良。与内镜检查结果正常的患者相比，胃炎患者持续性腹胀的发生率明显更高（p：0.000），但其发生率在溃疡患者和正常患者之间相当。考虑早饱发生率时，胃炎、溃疡和内镜检查正常的患者之间未检测到统计学差异。与内镜检查正常的患者相比，胃炎和溃疡患者的上腹部疼痛发生率明显更高（分别为p：0.002和p：0.000）。胃炎患者的烧心发生率高于内镜检查结果正常的患者，但与溃疡患者相似。
18至45岁无报警症状的患者中，大多数（67.1%）的诊断需要使用PPI。因此，在转诊进行内镜检查之前，应对患者进行仔细评估。
