IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort
BackgroundGastric intestinal metaplasia (GIM) is a precancerous lesion associated with dysplasia and gastric cancer (GC). Annually, 1.8%, 10% and 73% of patients with atrophic gastritis, GIM and dysplasia progress to GC. While dyspepsia is associated with Helicobacter Pylori and active gastritis, GI...
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| Veröffentlicht in: | Gut 2022-09, Vol.71 (Suppl 2), p.A59-A59 |
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| creator | Tang, Si-Ying Lee, Jonathan Koh, Calvin J Zhu, Feng So, Jimmy Ho, Khek-Yu Srivastava, Supriya Tsao, Stephen Khor, Christopher Fock, Kwong-Ming Lim, Wee-Chian Ling, Khoon-Lin Ang, Tiing-Leong Teh, Ming |
| description | BackgroundGastric intestinal metaplasia (GIM) is a precancerous lesion associated with dysplasia and gastric cancer (GC). Annually, 1.8%, 10% and 73% of patients with atrophic gastritis, GIM and dysplasia progress to GC. While dyspepsia is associated with Helicobacter Pylori and active gastritis, GIM is not thought to be associated with specific symptoms. The aim of the study is to evaluate the correlation between GIM and pre-endoscopy symptoms.Methods2874 participants underwent 7480 gastroscopies with updated Sydney System gastric mucosal sampling from January 2004 – December 2010 with GIM graded using the Operative Link in Gastric Intestinal Metaplasia (OLGIM) staging. Prior to each endoscopy, the participants completed a medical history interview reporting symptoms of dyspepsia, acid brash, heartburn, dysphagia, nausea, vomiting, early satiety, indigestion, loss of weight, loss of appetite, coffee ground vomitus and melena. Results were compiled and statistics calculated using R for chi-square and logistic regression analysis.ResultsGIM was present in 53.3% (n=3992) of the gastroscopies. One-third of the patients (37.1%, n=2781) were symptomatic prior to the endoscopy, with the most common symptoms being dyspepsia (n=1860, 24.9%), acid brash (n=838, 11.2%) and heartburn (n=520, 7%).Compared to controls, patients with GIM have lower proportions of symptoms (34.2% vs 39.8%, p |
| doi_str_mv | 10.1136/gutjnl-2022-IDDF.67 |
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| fullrecord | <record><control><sourceid>proquest_bmj_j</sourceid><recordid>TN_cdi_proquest_journals_2711023872</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2711023872</sourcerecordid><originalsourceid>FETCH-LOGICAL-b1137-e4574e10a8f84f174865ad88f93447a1f369bfbc6f7ef0a23148c4a249ab4c623</originalsourceid><addsrcrecordid>eNpFkL1OwzAUhS0EEqXwBCyWmE39V9sZS0tLpUoMwBzdBLskyk-JnYpuXZDYecM-CQlFYrrLd4_O-RC6ZvSWMaFG6zbkVUE45ZwsZ7P5rdInaMCkMkRwY07RgFKmyVjL6BxdeJ9TSo2J2AB99fjv3-TuiVDOxGH_uQAfmizFWRWsD1kFBS5tgE0BPgNcwg5DCLZqIVjcWFe0H9jvyk2oS48P-28M3cfOZx7XDgMuoFlbXCfeNlsIWd3HbZrab2wasq3Faf1WN-ESnTkovL36u0P0Mr9_nj6Q1eNiOZ2sSNIt1cTKboRlFIwz0jEtjRrDqzEuElJqYE6oKHFJqpy2jgIXTJpUApcRJDJVXAzRzTG3q_DedvPivG6brpOPuWaMcmF0T42OVFLm_wCjca87PuqOe21x7y9WWvwAMaF3kg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2711023872</pqid></control><display><type>article</type><title>IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort</title><source>PubMed Central</source><creator>Tang, Si-Ying ; Lee, Jonathan ; Koh, Calvin J ; Zhu, Feng ; So, Jimmy ; Ho, Khek-Yu ; Srivastava, Supriya ; Tsao, Stephen ; Khor, Christopher ; Fock, Kwong-Ming ; Lim, Wee-Chian ; Ling, Khoon-Lin ; Ang, Tiing-Leong ; Teh, Ming</creator><creatorcontrib>Tang, Si-Ying ; Lee, Jonathan ; Koh, Calvin J ; Zhu, Feng ; So, Jimmy ; Ho, Khek-Yu ; Srivastava, Supriya ; Tsao, Stephen ; Khor, Christopher ; Fock, Kwong-Ming ; Lim, Wee-Chian ; Ling, Khoon-Lin ; Ang, Tiing-Leong ; Teh, Ming</creatorcontrib><description><![CDATA[BackgroundGastric intestinal metaplasia (GIM) is a precancerous lesion associated with dysplasia and gastric cancer (GC). Annually, 1.8%, 10% and 73% of patients with atrophic gastritis, GIM and dysplasia progress to GC. While dyspepsia is associated with Helicobacter Pylori and active gastritis, GIM is not thought to be associated with specific symptoms. The aim of the study is to evaluate the correlation between GIM and pre-endoscopy symptoms.Methods2874 participants underwent 7480 gastroscopies with updated Sydney System gastric mucosal sampling from January 2004 – December 2010 with GIM graded using the Operative Link in Gastric Intestinal Metaplasia (OLGIM) staging. Prior to each endoscopy, the participants completed a medical history interview reporting symptoms of dyspepsia, acid brash, heartburn, dysphagia, nausea, vomiting, early satiety, indigestion, loss of weight, loss of appetite, coffee ground vomitus and melena. Results were compiled and statistics calculated using R for chi-square and logistic regression analysis.ResultsGIM was present in 53.3% (n=3992) of the gastroscopies. One-third of the patients (37.1%, n=2781) were symptomatic prior to the endoscopy, with the most common symptoms being dyspepsia (n=1860, 24.9%), acid brash (n=838, 11.2%) and heartburn (n=520, 7%).Compared to controls, patients with GIM have lower proportions of symptoms (34.2% vs 39.8%, p<0.01). Of note, patients with GIM reported significantly less acid brash (9.5% vs 12.7%, p<0.01) and heartburn (5.2% vs 8.5%, p<0.01) (IDDF2022-ABS-0213 Table1), whereby H. pylori status was not significantly different in these subgroups.Abstract IDDF2022-ABS-0213 Table 1Symptoms in patients with or without GIM Symptoms No GIM (%) GIM (%) Total (%) P-value Odds ratio (CI) Acid brash No 3484 (87.3) 3158 (90.5) 6642 (88.8) <0.001 0.72 (0.62–0.83) Yes 508 (12.7) 330 (9.5) 838 (11.2) Heartburn No 3653 (91.5) 3307 (94.8) 6960 (93.0) <0.001 0.59 (0.49 - 0.71) Yes 339 (8.5) 181 (5.2) 520 (7.0) Dysphagia No 3939 (98.7) 3462 (99.3) 7401 (98.9) 0.019 0.56 (0.35 - 0.89) Yes 53 (1.3) 26 (0.7) 79 (1.1) Nausea No 3868 (96.9) 3418 (98.0) 7286 (97.4) 0.004 0.64 (0.47 - 0.86) Yes 124 (3.1) 70 (2.0) 194 (2.6) Vomiting No 3963 (99.3) 3463 (99.3) 7426 (99.3) 1.000 0.99 (0.58 - 1.69) Yes 29 (0.7) 25 (0.7) 54 (0.7) Dyspepsia No 2932 (73.4) 2688 (77.1) 5620 (75.1) <0.001 0.82 (0.74 - 0.91) Yes 1060 (26.6) 800 (22.9) 1860 (24.9) Satiety No 3829 (95.9) 3365 (96.5) 7194 (96.2) 0.233 0.86 (0.68 - 1.09) Yes 163 (4.1) 123 (3.5) 286 (3.8) Indigestion No 3878 (97.1) 3420 (98.1) 7298 (97.6) 0.014 0.68 (0.50 - 0.92) Yes 114 (2.9) 68 (1.9) 182 (2.4) LOA No 3941 (98.7) 3463 (99.3) 7404 (99.0) 0.022 0.56 (0.34 - 0.92) Yes 51 (1.3) 25 (0.7) 76 (1.0) LOW No 3889 (97.4) 3425 (98.2) 7314 (97.8) 0.029 0.69 (0.51 - 0.95) Yes 103 (2.6) 63 (1.8) 166 (2.2) Coffeeground No 3986 (99.8) 3485 (99.9) 7471 (99.9) 0.641 0.57 (0.14 – 2.29) Yes 6 (0.2) 3 (0.1) 9 (0.1) Melena No 3967 (99.4) 3470 (99.5) 7437 (99.4) 0.634 0.82 (0.45 – 1.51) Yes 25 (0.6) 18 (0.5) 43 (0.6) Symptomatic No 2404 (60.2) 2295 (65.8) 4699 (62.8) <0.001 0.79 (0.72 -0.86) Yes 1588 (39.8) 1193 (34.2) 2781 (37.2) ConclusionsWe hypothesize that patients with intestinal metaplasia and atrophic gastritis may have less acid secretion, and correspondingly fewer reflux symptoms. Although many patients in clinical practice, are scoped for dyspepsia and reflux symptoms, our data suggest that patients with GIM are less likely to have these symptoms and yet harbour this pre-malignant condition of the stomach.]]></description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2022-IDDF.67</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Acids ; Appetite loss ; Basic Gastroenterology ; Coffee ; Dyspepsia ; Dysphagia ; Dysplasia ; Endoscopy ; Gastric cancer ; Gastric mucosa ; Gastritis ; Gastroesophageal reflux ; Heart ; Helicobacter pylori ; Intestine ; Metaplasia ; Nausea ; Patients ; Satiety ; Statistical analysis ; Vomiting</subject><ispartof>Gut, 2022-09, Vol.71 (Suppl 2), p.A59-A59</ispartof><rights>Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Tang, Si-Ying</creatorcontrib><creatorcontrib>Lee, Jonathan</creatorcontrib><creatorcontrib>Koh, Calvin J</creatorcontrib><creatorcontrib>Zhu, Feng</creatorcontrib><creatorcontrib>So, Jimmy</creatorcontrib><creatorcontrib>Ho, Khek-Yu</creatorcontrib><creatorcontrib>Srivastava, Supriya</creatorcontrib><creatorcontrib>Tsao, Stephen</creatorcontrib><creatorcontrib>Khor, Christopher</creatorcontrib><creatorcontrib>Fock, Kwong-Ming</creatorcontrib><creatorcontrib>Lim, Wee-Chian</creatorcontrib><creatorcontrib>Ling, Khoon-Lin</creatorcontrib><creatorcontrib>Ang, Tiing-Leong</creatorcontrib><creatorcontrib>Teh, Ming</creatorcontrib><title>IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort</title><title>Gut</title><addtitle>Gut</addtitle><description><![CDATA[BackgroundGastric intestinal metaplasia (GIM) is a precancerous lesion associated with dysplasia and gastric cancer (GC). Annually, 1.8%, 10% and 73% of patients with atrophic gastritis, GIM and dysplasia progress to GC. While dyspepsia is associated with Helicobacter Pylori and active gastritis, GIM is not thought to be associated with specific symptoms. The aim of the study is to evaluate the correlation between GIM and pre-endoscopy symptoms.Methods2874 participants underwent 7480 gastroscopies with updated Sydney System gastric mucosal sampling from January 2004 – December 2010 with GIM graded using the Operative Link in Gastric Intestinal Metaplasia (OLGIM) staging. Prior to each endoscopy, the participants completed a medical history interview reporting symptoms of dyspepsia, acid brash, heartburn, dysphagia, nausea, vomiting, early satiety, indigestion, loss of weight, loss of appetite, coffee ground vomitus and melena. Results were compiled and statistics calculated using R for chi-square and logistic regression analysis.ResultsGIM was present in 53.3% (n=3992) of the gastroscopies. One-third of the patients (37.1%, n=2781) were symptomatic prior to the endoscopy, with the most common symptoms being dyspepsia (n=1860, 24.9%), acid brash (n=838, 11.2%) and heartburn (n=520, 7%).Compared to controls, patients with GIM have lower proportions of symptoms (34.2% vs 39.8%, p<0.01). Of note, patients with GIM reported significantly less acid brash (9.5% vs 12.7%, p<0.01) and heartburn (5.2% vs 8.5%, p<0.01) (IDDF2022-ABS-0213 Table1), whereby H. pylori status was not significantly different in these subgroups.Abstract IDDF2022-ABS-0213 Table 1Symptoms in patients with or without GIM Symptoms No GIM (%) GIM (%) Total (%) P-value Odds ratio (CI) Acid brash No 3484 (87.3) 3158 (90.5) 6642 (88.8) <0.001 0.72 (0.62–0.83) Yes 508 (12.7) 330 (9.5) 838 (11.2) Heartburn No 3653 (91.5) 3307 (94.8) 6960 (93.0) <0.001 0.59 (0.49 - 0.71) Yes 339 (8.5) 181 (5.2) 520 (7.0) Dysphagia No 3939 (98.7) 3462 (99.3) 7401 (98.9) 0.019 0.56 (0.35 - 0.89) Yes 53 (1.3) 26 (0.7) 79 (1.1) Nausea No 3868 (96.9) 3418 (98.0) 7286 (97.4) 0.004 0.64 (0.47 - 0.86) Yes 124 (3.1) 70 (2.0) 194 (2.6) Vomiting No 3963 (99.3) 3463 (99.3) 7426 (99.3) 1.000 0.99 (0.58 - 1.69) Yes 29 (0.7) 25 (0.7) 54 (0.7) Dyspepsia No 2932 (73.4) 2688 (77.1) 5620 (75.1) <0.001 0.82 (0.74 - 0.91) Yes 1060 (26.6) 800 (22.9) 1860 (24.9) Satiety No 3829 (95.9) 3365 (96.5) 7194 (96.2) 0.233 0.86 (0.68 - 1.09) Yes 163 (4.1) 123 (3.5) 286 (3.8) Indigestion No 3878 (97.1) 3420 (98.1) 7298 (97.6) 0.014 0.68 (0.50 - 0.92) Yes 114 (2.9) 68 (1.9) 182 (2.4) LOA No 3941 (98.7) 3463 (99.3) 7404 (99.0) 0.022 0.56 (0.34 - 0.92) Yes 51 (1.3) 25 (0.7) 76 (1.0) LOW No 3889 (97.4) 3425 (98.2) 7314 (97.8) 0.029 0.69 (0.51 - 0.95) Yes 103 (2.6) 63 (1.8) 166 (2.2) Coffeeground No 3986 (99.8) 3485 (99.9) 7471 (99.9) 0.641 0.57 (0.14 – 2.29) Yes 6 (0.2) 3 (0.1) 9 (0.1) Melena No 3967 (99.4) 3470 (99.5) 7437 (99.4) 0.634 0.82 (0.45 – 1.51) Yes 25 (0.6) 18 (0.5) 43 (0.6) Symptomatic No 2404 (60.2) 2295 (65.8) 4699 (62.8) <0.001 0.79 (0.72 -0.86) Yes 1588 (39.8) 1193 (34.2) 2781 (37.2) ConclusionsWe hypothesize that patients with intestinal metaplasia and atrophic gastritis may have less acid secretion, and correspondingly fewer reflux symptoms. Although many patients in clinical practice, are scoped for dyspepsia and reflux symptoms, our data suggest that patients with GIM are less likely to have these symptoms and yet harbour this pre-malignant condition of the stomach.]]></description><subject>Acids</subject><subject>Appetite loss</subject><subject>Basic Gastroenterology</subject><subject>Coffee</subject><subject>Dyspepsia</subject><subject>Dysphagia</subject><subject>Dysplasia</subject><subject>Endoscopy</subject><subject>Gastric cancer</subject><subject>Gastric mucosa</subject><subject>Gastritis</subject><subject>Gastroesophageal reflux</subject><subject>Heart</subject><subject>Helicobacter pylori</subject><subject>Intestine</subject><subject>Metaplasia</subject><subject>Nausea</subject><subject>Patients</subject><subject>Satiety</subject><subject>Statistical analysis</subject><subject>Vomiting</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpFkL1OwzAUhS0EEqXwBCyWmE39V9sZS0tLpUoMwBzdBLskyk-JnYpuXZDYecM-CQlFYrrLd4_O-RC6ZvSWMaFG6zbkVUE45ZwsZ7P5rdInaMCkMkRwY07RgFKmyVjL6BxdeJ9TSo2J2AB99fjv3-TuiVDOxGH_uQAfmizFWRWsD1kFBS5tgE0BPgNcwg5DCLZqIVjcWFe0H9jvyk2oS48P-28M3cfOZx7XDgMuoFlbXCfeNlsIWd3HbZrab2wasq3Faf1WN-ESnTkovL36u0P0Mr9_nj6Q1eNiOZ2sSNIt1cTKboRlFIwz0jEtjRrDqzEuElJqYE6oKHFJqpy2jgIXTJpUApcRJDJVXAzRzTG3q_DedvPivG6brpOPuWaMcmF0T42OVFLm_wCjca87PuqOe21x7y9WWvwAMaF3kg</recordid><startdate>20220902</startdate><enddate>20220902</enddate><creator>Tang, Si-Ying</creator><creator>Lee, Jonathan</creator><creator>Koh, Calvin J</creator><creator>Zhu, Feng</creator><creator>So, Jimmy</creator><creator>Ho, Khek-Yu</creator><creator>Srivastava, Supriya</creator><creator>Tsao, Stephen</creator><creator>Khor, Christopher</creator><creator>Fock, Kwong-Ming</creator><creator>Lim, Wee-Chian</creator><creator>Ling, Khoon-Lin</creator><creator>Ang, Tiing-Leong</creator><creator>Teh, Ming</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20220902</creationdate><title>IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort</title><author>Tang, Si-Ying ; Lee, Jonathan ; Koh, Calvin J ; Zhu, Feng ; So, Jimmy ; Ho, Khek-Yu ; Srivastava, Supriya ; Tsao, Stephen ; Khor, Christopher ; Fock, Kwong-Ming ; Lim, Wee-Chian ; Ling, Khoon-Lin ; Ang, Tiing-Leong ; Teh, Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1137-e4574e10a8f84f174865ad88f93447a1f369bfbc6f7ef0a23148c4a249ab4c623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acids</topic><topic>Appetite loss</topic><topic>Basic Gastroenterology</topic><topic>Coffee</topic><topic>Dyspepsia</topic><topic>Dysphagia</topic><topic>Dysplasia</topic><topic>Endoscopy</topic><topic>Gastric cancer</topic><topic>Gastric mucosa</topic><topic>Gastritis</topic><topic>Gastroesophageal reflux</topic><topic>Heart</topic><topic>Helicobacter pylori</topic><topic>Intestine</topic><topic>Metaplasia</topic><topic>Nausea</topic><topic>Patients</topic><topic>Satiety</topic><topic>Statistical analysis</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tang, Si-Ying</creatorcontrib><creatorcontrib>Lee, Jonathan</creatorcontrib><creatorcontrib>Koh, Calvin J</creatorcontrib><creatorcontrib>Zhu, Feng</creatorcontrib><creatorcontrib>So, Jimmy</creatorcontrib><creatorcontrib>Ho, Khek-Yu</creatorcontrib><creatorcontrib>Srivastava, Supriya</creatorcontrib><creatorcontrib>Tsao, Stephen</creatorcontrib><creatorcontrib>Khor, Christopher</creatorcontrib><creatorcontrib>Fock, Kwong-Ming</creatorcontrib><creatorcontrib>Lim, Wee-Chian</creatorcontrib><creatorcontrib>Ling, Khoon-Lin</creatorcontrib><creatorcontrib>Ang, Tiing-Leong</creatorcontrib><creatorcontrib>Teh, Ming</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tang, Si-Ying</au><au>Lee, Jonathan</au><au>Koh, Calvin J</au><au>Zhu, Feng</au><au>So, Jimmy</au><au>Ho, Khek-Yu</au><au>Srivastava, Supriya</au><au>Tsao, Stephen</au><au>Khor, Christopher</au><au>Fock, Kwong-Ming</au><au>Lim, Wee-Chian</au><au>Ling, Khoon-Lin</au><au>Ang, Tiing-Leong</au><au>Teh, Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><date>2022-09-02</date><risdate>2022</risdate><volume>71</volume><issue>Suppl 2</issue><spage>A59</spage><epage>A59</epage><pages>A59-A59</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract><![CDATA[BackgroundGastric intestinal metaplasia (GIM) is a precancerous lesion associated with dysplasia and gastric cancer (GC). Annually, 1.8%, 10% and 73% of patients with atrophic gastritis, GIM and dysplasia progress to GC. While dyspepsia is associated with Helicobacter Pylori and active gastritis, GIM is not thought to be associated with specific symptoms. The aim of the study is to evaluate the correlation between GIM and pre-endoscopy symptoms.Methods2874 participants underwent 7480 gastroscopies with updated Sydney System gastric mucosal sampling from January 2004 – December 2010 with GIM graded using the Operative Link in Gastric Intestinal Metaplasia (OLGIM) staging. Prior to each endoscopy, the participants completed a medical history interview reporting symptoms of dyspepsia, acid brash, heartburn, dysphagia, nausea, vomiting, early satiety, indigestion, loss of weight, loss of appetite, coffee ground vomitus and melena. Results were compiled and statistics calculated using R for chi-square and logistic regression analysis.ResultsGIM was present in 53.3% (n=3992) of the gastroscopies. One-third of the patients (37.1%, n=2781) were symptomatic prior to the endoscopy, with the most common symptoms being dyspepsia (n=1860, 24.9%), acid brash (n=838, 11.2%) and heartburn (n=520, 7%).Compared to controls, patients with GIM have lower proportions of symptoms (34.2% vs 39.8%, p<0.01). Of note, patients with GIM reported significantly less acid brash (9.5% vs 12.7%, p<0.01) and heartburn (5.2% vs 8.5%, p<0.01) (IDDF2022-ABS-0213 Table1), whereby H. pylori status was not significantly different in these subgroups.Abstract IDDF2022-ABS-0213 Table 1Symptoms in patients with or without GIM Symptoms No GIM (%) GIM (%) Total (%) P-value Odds ratio (CI) Acid brash No 3484 (87.3) 3158 (90.5) 6642 (88.8) <0.001 0.72 (0.62–0.83) Yes 508 (12.7) 330 (9.5) 838 (11.2) Heartburn No 3653 (91.5) 3307 (94.8) 6960 (93.0) <0.001 0.59 (0.49 - 0.71) Yes 339 (8.5) 181 (5.2) 520 (7.0) Dysphagia No 3939 (98.7) 3462 (99.3) 7401 (98.9) 0.019 0.56 (0.35 - 0.89) Yes 53 (1.3) 26 (0.7) 79 (1.1) Nausea No 3868 (96.9) 3418 (98.0) 7286 (97.4) 0.004 0.64 (0.47 - 0.86) Yes 124 (3.1) 70 (2.0) 194 (2.6) Vomiting No 3963 (99.3) 3463 (99.3) 7426 (99.3) 1.000 0.99 (0.58 - 1.69) Yes 29 (0.7) 25 (0.7) 54 (0.7) Dyspepsia No 2932 (73.4) 2688 (77.1) 5620 (75.1) <0.001 0.82 (0.74 - 0.91) Yes 1060 (26.6) 800 (22.9) 1860 (24.9) Satiety No 3829 (95.9) 3365 (96.5) 7194 (96.2) 0.233 0.86 (0.68 - 1.09) Yes 163 (4.1) 123 (3.5) 286 (3.8) Indigestion No 3878 (97.1) 3420 (98.1) 7298 (97.6) 0.014 0.68 (0.50 - 0.92) Yes 114 (2.9) 68 (1.9) 182 (2.4) LOA No 3941 (98.7) 3463 (99.3) 7404 (99.0) 0.022 0.56 (0.34 - 0.92) Yes 51 (1.3) 25 (0.7) 76 (1.0) LOW No 3889 (97.4) 3425 (98.2) 7314 (97.8) 0.029 0.69 (0.51 - 0.95) Yes 103 (2.6) 63 (1.8) 166 (2.2) Coffeeground No 3986 (99.8) 3485 (99.9) 7471 (99.9) 0.641 0.57 (0.14 – 2.29) Yes 6 (0.2) 3 (0.1) 9 (0.1) Melena No 3967 (99.4) 3470 (99.5) 7437 (99.4) 0.634 0.82 (0.45 – 1.51) Yes 25 (0.6) 18 (0.5) 43 (0.6) Symptomatic No 2404 (60.2) 2295 (65.8) 4699 (62.8) <0.001 0.79 (0.72 -0.86) Yes 1588 (39.8) 1193 (34.2) 2781 (37.2) ConclusionsWe hypothesize that patients with intestinal metaplasia and atrophic gastritis may have less acid secretion, and correspondingly fewer reflux symptoms. Although many patients in clinical practice, are scoped for dyspepsia and reflux symptoms, our data suggest that patients with GIM are less likely to have these symptoms and yet harbour this pre-malignant condition of the stomach.]]></abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><doi>10.1136/gutjnl-2022-IDDF.67</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0017-5749 |
| ispartof | Gut, 2022-09, Vol.71 (Suppl 2), p.A59-A59 |
| issn | 0017-5749 1468-3288 |
| language | eng |
| recordid | cdi_proquest_journals_2711023872 |
| source | PubMed Central |
| subjects | Acids Appetite loss Basic Gastroenterology Coffee Dyspepsia Dysphagia Dysplasia Endoscopy Gastric cancer Gastric mucosa Gastritis Gastroesophageal reflux Heart Helicobacter pylori Intestine Metaplasia Nausea Patients Satiety Statistical analysis Vomiting |
| title | IDDF2022-ABS-0213 Gastric intestinal metaplasia may attenuate reflux symptoms – analysis of a large observational prospective cohort |
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