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Clinical value of random esophageal biopsies in patients with dysphagia and normal endoscopy who are treated with a proton pump inhibitor.
Kamionkowski, Sara; Shibli, Fahmi; Saleh, Sherif; Trujillo, Sophie; Mengalle, Erika; El Mokahal, Ali; Thomas, Charles; Song, Gengqing; Fass, Ronnie.
Afiliación
  • Kamionkowski S; Department of Internal Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Shibli F; Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Saleh S; Department of Internal Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Trujillo S; Department of Internal Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Mengalle E; Department of Internal Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • El Mokahal A; Department of Internal Medicine, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Thomas C; Department of Research and Scholarship, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Song G; Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
  • Fass R; Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
Dis Esophagus ; 37(4)2024 Apr 02.
Article en En | MEDLINE | ID: mdl-38197434
ABSTRACT
Rome IV recommended esophageal biopsies in patients with dysphagia and normal endoscopy to exclude mucosal disease. Thus far, studies evaluating the utility of this recommendation remain scarce. The aims of this study were to determine the value of random esophageal biopsies in heartburn patients with dysphagia and normal endoscopy and compare the yield of random esophageal biopsies between younger versus older patients. Data were collected from consecutive patients presenting with dysphagia, 18 years and older, who were on proton pump inhibitors and had normal upper endoscopy. Biopsy results of patients with and without heartburn were recorded. Logistic regression analysis was used to compare normal versus abnormal biopsy results in younger and older patients accounting for confounding variables. The number of abnormal biopsies was significantly higher than normal biopsies (68% and 32%, respectively, P = 0.0001). Among abnormal biopsy results, microscopic gastroesophageal reflux disease was significantly more common than all other findings (39%, P = 0.0495). There was no significant difference in biopsy results in patients with and without heartburn as well as younger versus older patients (P = 0.3384, P = 0.1010, and P = 0.8468, respectively). Our study demonstrated that most patients with dysphagia and normal upper endoscopy who are on proton pump inhibitor have some type of histologic mucosal abnormality, which can direct future management. Among abnormal biopsies, microscopic reflux was by far the most common finding in patients with or without a history of heartburn. While this supports the management strategy proposed by Rome IV, age did not drive esophageal biopsy results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Reflujo Gastroesofágico Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Dis Esophagus Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos de Deglución / Reflujo Gastroesofágico Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: Dis Esophagus Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos