BACKGROUND: It is difficult to decide which patients with reflux symptoms require endoscopy. The aim of this study was to develop a scoring system to predict esophageal findings at endoscopy. METHODS: A consecutive sample of 1011 adult patients scheduled for upper endoscopy were asked to complete a validated symptom questionnaire. The endoscopy reports were abstracted. Individual logistic regression models were developed to predict esophagitis, Barrett's esophagus (long and short segment) and esophageal stricture, including Schatzki's ring. RESULTS: Reflux esophagitis was independently associated with heartburn frequency (p<0.0001) but not severity or duration (p>0.05). Barrett's esophagus was associated with the duration of acid regurgitation (p<0.005) but not with frequency or severity (p>0.05). Strictures were associated with dysphagia severity (p<0.0001) and duration (p<0.0001) but not frequency (p>0.05). At a sensitivity of 80%, the models had a specificity of 49% for esophagitis, 57% for Barrett's esophagus, and 68% for strictures. At a specificity of 80%, the sensitivities were 51% for esophagitis, 62% for Barrett's esophagus and 71% for strictures. CONCLUSIONS: Endoscopic findings were associated with distinct attributes of reflux symptoms. Symptoms are only modestly predictive of findings at endoscopy.
BACKGROUND: It is difficult to decide which patients with reflux symptoms require endoscopy. The aim of this study was to develop a scoring system to predict esophageal findings at endoscopy. METHODS: A consecutive sample of 1011 adult patients scheduled for upper endoscopy were asked to complete a validated symptom questionnaire. The endoscopy reports were abstracted. Individual logistic regression models were developed to predict esophagitis, Barrett's esophagus (long and short segment) and esophageal stricture, including Schatzki's ring. RESULTS:Reflux esophagitis was independently associated with heartburn frequency (p<0.0001) but not severity or duration (p>0.05). Barrett's esophagus was associated with the duration of acid regurgitation (p<0.005) but not with frequency or severity (p>0.05). Strictures were associated with dysphagia severity (p<0.0001) and duration (p<0.0001) but not frequency (p>0.05). At a sensitivity of 80%, the models had a specificity of 49% for esophagitis, 57% for Barrett's esophagus, and 68% for strictures. At a specificity of 80%, the sensitivities were 51% for esophagitis, 62% for Barrett's esophagus and 71% for strictures. CONCLUSIONS: Endoscopic findings were associated with distinct attributes of reflux symptoms. Symptoms are only modestly predictive of findings at endoscopy.
Authors: Avi Rosenfeld; David G Graham; Sarah Jevons; Jose Ariza; Daryl Hagan; Ash Wilson; Samuel J Lovat; Sarmed S Sami; Omer F Ahmad; Marco Novelli; Manuel Rodriguez Justo; Alison Winstanley; Eliyahu M Heifetz; Mordehy Ben-Zecharia; Uria Noiman; Rebecca C Fitzgerald; Peter Sasieni; Laurence B Lovat Journal: Lancet Digit Health Date: 2019-12-05
Authors: Aaron P Thrift; Michael B Cook; Thomas L Vaughan; Lesley A Anderson; Liam J Murray; David C Whiteman; Nicholas J Shaheen; Douglas A Corley Journal: Am J Gastroenterol Date: 2014-07-22 Impact factor: 10.864
Authors: Katie S Nason; Promporn Paula Wichienkuer; Omar Awais; Matthew J Schuchert; James D Luketich; Robert W O'Rourke; John G Hunter; Cynthia D Morris; Blair A Jobe Journal: Arch Surg Date: 2011-07
Authors: Joel H Rubenstein; Hal Morgenstern; Henry Appelman; James Scheiman; Philip Schoenfeld; Laurence F McMahon; Valbona Metko; Ellen Near; Joan Kellenberg; Tal Kalish; John M Inadomi Journal: Am J Gastroenterol Date: 2013-01-15 Impact factor: 10.864