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The Role of Gastroesophageal Reflux (GER) in Patients with Nonspecific Upper GI Symptoms

MOHAMMAD FARIVAR and JAMES KOLTON, DEPT of MEDICINE and DEPT of PATHOLOGY, NORWOOD HOSPITAL, NORWOOD, MA

Nineteen consecutive patients (12 female, 7 male) underwent upper GI endoscopy (EGD) for evaluation of one or more symptoms of bloating, early satiety, anorexia, nausea, vomiting and upper abdominal pain. They denied heartburn, chest pain, diarrhea or constipation. There was no evidence of G.I. blood loss. Upper abdominal ultrasound was normal in all and upper G.I. x-ray was unremarkable in 8 of 8. In each patient, laryngo-esophago-gastro-duodenoscopy (LEGD) was done, and 4 pinch biopsies were taken 2-4 cm from the gastro-esophageal junction to look for microscopic chronic esophagitis.

Results: Endoscopy revealed gastritis, duodenitis, gastric ulcer or erosive esophagitis in 9 patients (47%). 13 patients (68%) had reflux laryngitis (RL). 13 patients (68%) had chronic esophagitis by biopsy. 10 patients (53%) were found to have both positive biopsy and RL. Only 2 of 10 patients had endoscopic esophagitis (grades I-III). Of 3 patients with negative biopsy and no RL, one had gastric ulcer and one had grade II esophagitis. GER patients responded to appropriate medical treatment.

Conclusions: In this study of 19 patients with non-specific upper GI symptoms, at least 10 (53%) had clinically unsuspected reflux, as proven by both positive biopsy and the presence of RL during LEGD. All patients responded clinically to anti-reflux treatment.

 

 

 

 

 

         This is an educational site created by M. Farivar, M.D. The information provided is the author's opinion based on years of clinical experience and research.  You are advised to consult your own physician about the applicability of this information to your particular needs.  Also, keep in mind that symptom response to therapy does not preclude the presence of more serious conditions. 

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