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Association of endoscopic appearances with dyspeptic symptoms

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Abstract

Background

The relationship between endoscopic appearances such as endoscopic gastritis and duodenitis and dyspeptic symptoms has not been clearly demonstrated. We aimed to clarify the association of endoscopic appearances with Helicobacter pylori infection, histological severity of gastritis, and dyspeptic symptoms in a Japanese population.

Methods

We enrolled 87 dyspeptic and 93 nondyspeptic subjects in this study. All subjects underwent gastroscopy, and patients with active peptic ulcer disease, reflex esophagitis with erosion, polyps >1 cm, or cancer were excluded. Endoscopic appearances in patients with dyspeptic symptoms and in those without were assessed retrospectively on the basis of endoscopic images. The degree of atrophy by the Kimura-Takemoto classification system was also assessed. Helicobacter pylori infection status was examined by histology or antibody against H. pylori. Histological severity of inflammation and glandular atrophy in the antrum were assessed according to the updated Sydney System. The odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression using the variables age, sex, H. pylori infection status, and all endoscopic appearances.

Results

The degree of atrophy tended to be lower among dyspeptic patients (P = 0.06). Among all endoscopic appearances, the liner redness (friability) in the antrum (OR = 3.90, 95% CI = 1.20−12.64) and duodenal ulcer (DU) scarring (OR = 3.41, 95% CI = 1.08−10.79) were independently associated with dyspepsia. Histological severity of inflammation and glandular atrophy were not associated with dyspeptic symptoms. Also, no correlation was found between endoscopic appearances and any of the different subgroups of dyspeptic symptoms. Patients with friability in the antrum and DU scar, which correlated with dyspeptic symptom showed some of communal symptoms such as epigastric pain, epigastric discomfort, hypochondriac pain, early satiation/postprandial fullness, and belching, but they differed considerably with respect to H. pylori positivity and the histological severity of gastritis.

Conclusions

Some endoscopic appearances such as friability in the antrum and DU scarring may be associated with dyspeptic symptoms, and endoscopic appearances may be useful markers to perform clinical implementation reflecting an individual’s pathophysiology of dyspeptic symptoms.

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Authors and Affiliations

  1. Department of Gastroenterology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Japan

    Tomomitsu Tahara, Tomiyasu Arisawa, Tomoyuki Shibata, Masakatsu Nakamura, Masaaki Okubo, Daisuke Yoshioka, Fangyu Wang & Ichiro Hirata

  2. Fujita Health University, Toyoake, Japan

    Hiroshi Nakano

Authors
  1. Tomomitsu Tahara
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  2. Tomiyasu Arisawa
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  3. Tomoyuki Shibata
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  4. Masakatsu Nakamura
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  5. Masaaki Okubo
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  6. Daisuke Yoshioka
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  7. Fangyu Wang
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  8. Hiroshi Nakano
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  9. Ichiro Hirata
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Tahara, T., Arisawa, T., Shibata, T. et al. Association of endoscopic appearances with dyspeptic symptoms. J Gastroenterol 43, 208–215 (2008). https://doi.org/10.1007/s00535-007-2149-2

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  • DOI: https://doi.org/10.1007/s00535-007-2149-2

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