• Title/Summary/Keyword: Upper Gastrointestinal Disease

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Upper Gastrointestinal Cancer and Reflux Disease

  • Kim, Jin-Jo
    • Journal of Gastric Cancer
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    • v.13 no.2
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    • pp.79-85
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    • 2013
  • There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.

Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents

  • Kim, Eun Sil;Kim, Mi Jin
    • Clinical and Experimental Pediatrics
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    • v.65 no.1
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    • pp.21-28
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    • 2022
  • Crohn disease (CD) is a multifactorial inflammatory disorder that can affect all segments of the gastrointestinal (GI) tract but typically involves the ileum and/or colon. To assess patient prognosis and choose appropriate treatment, it is necessary to accurately evaluate the factors influencing poor outcomes, including disease phenotype. Pediatric CD involving the upper GI (UGI) tract has become increasingly recognized with the introduction of routine upper endoscopy with biopsies for all patients and the increased availability of accurate small bowel evaluations. Most clinical manifestations are mild and nonspecific; however, UGI involvement should not be overlooked since it can cause serious complications. Although controversy persists about the definition of upper GI involvement, aphthoid ulcers, longitudinal ulcers, a bamboo joint-like appearance, stenosis, and fistula are endoscopic findings suggestive of CD. In addition, the primary histological findings, such as focally enhanced gastritis and noncaseating granulomas, are highly suggestive of CD. The association between UGI involvement and poor prognosis of CD remains controversial. However, the unstandardized definition and absence of a validated tool for evaluating disease severity complicate the objective assessment of UGI involvement in CD. Therefore, more prospective studies are needed to provide further insight into the standardized assessment of UGI involvement and long-term prognosis of CD. Our review summarizes the findings to date in the literature as well as UGI involvement in CD and its clinical implications.

Gastric neurofibroma in von Recklinghausen disease : a cause of upper gastrointestinal bleeding (Von Recklinghausen disease병 환아에서 상부위장관 출혈로 발현한 위의 신경섬유종 1례)

  • Kwon, Bo Sang;Shim, Jeong Ok;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Jung, Seong Eun;Kim, Woo Sun;Kang, Gyeong Hoon
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.203-207
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    • 2006
  • Neurofibromatosis type 1 (von Recklinghausen disease, NF1) involves the central and peripheral nervous systems as well as the skin, bone, endocrine, gastrointestinal and vascular systems. The gastrointestinal neurofibroma associated with NF1 has been infrequently reported. We report our experience with a 15-year-old boy who had a gastric plexiform neurofibroma with upper gastrointestinal bleeding and underwent a tumorectomy because of massive upper gastrointestinal bleeding. We conclude that gastrointestinal bleeding and anemia in the setting of NF1 mandates complete endoscopic examination of the digestive tract to rule out neurofibromas. Surgical resection is the standard treatment.

Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study

  • Park, Ji Hyoung;Nam, Hye Na;Lee, Ji-Hyuk;Hong, Jeana;Yi, Dae Yong;Ryoo, Eell;Jeon, In Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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    • pp.227-235
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    • 2017
  • Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

Comparative Study on Influencing Factors and Digestive Symptoms among Upper Gastrointestinal Disease Groups (상부 위장관 질환군별 영향 요인 및 소화기 증상에 관한 비교 연구)

  • Oh, Doo-Nam
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.335-346
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    • 2011
  • The aim of this study is to compare the differences of influencing factors and subjective digestive symptoms among upper gastrointestinal disease groups. Subjects of this study are the results of Helicobactor Pylori test, gastrofibroscopic findings, and the electronic data of medical questionnaires on individuals at the age of 20 to 79 who visited a Health Promotion Center in Seoul from October, 2003 to October, 2004. 2,708 cases are analysed for final with $x^2$ test and ANOVA test. The sociodemographic factors of sex, age and occupation, the living habits factors of smoking and drinking, the pathophysiological factor of H. pylori infection, and the psychological factor of stress show statistically significant differences among groups. The digestive symptoms of "the feeling of something remained in the stomach", "the burning feeling right after eating or at the empty state of stomach" and "the frequent reflux of watery acid from the stomach" show statistically significant differences among groups. This study provides meaningful data in finding distinctive features of each disease and will be applied as basic materials to the development of intervention methods for health promotion relating to the upper gastrointestinal diseases.

A Case of Dieulafoy's Disease in a Child (소아의 Dieulafoy병 치험 1례)

  • Lee, Eui-Sung;Oh, Chang-Hee;Kim, Je-Woo;Chung, Ki-Sup;Han, Suk-Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.80-84
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    • 1999
  • Dieulafoy's disease, a vascular anomaly mainly in the upper stomach, is a rare but potentially life-threatening cause of upper gastrointestinal bleeding. Pathogenesis is still controversial, but the most accepted theory is that a persistent caliber vessel in the submucosa is exposed by a small mucosal erosion leading to massive bleeding. The bleeding site is usually within 6 cm of the esophagogastric junction in the cardia or fundus of the stomach. The treatment of choice is therapeutic endoscopy or surgery. The age of patients reported is mainly between 50 and 70 years, and patients of pediatric age are extremely rare. We are reporting a 5-year-old male patient who had Dieulafoy's disease which was diagnosed by emergency upper gastrointestinal endoscopy. Endoscopic finding was a nodular lesion with an adherent clot on the lessor curvature of the stomach 2 cm below the esophagogastric junction. Epinephrine and $Beriplast^{(R)}$ was injected in the lesion. On the second day after endoscopic sclerotherapy, the patient had recurred massive hematemesis and accompanying shock. So we performed gastrotomy and ligation. After the operation, he showed an improved general condition and was discharged at the 12th hospital day.

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Endoscopy Finding of Patients Who Complained of the Upper Digestive Symptoms after Taking Oriental Herb Decoctions

  • Kim, Dong-Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.987-992
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    • 2008
  • This study was carried out to understand the macroscopic aspects of the digestive system symptoms occurring after taking oriental herb complex decoction as observing morphological changes in esophagus, stomach and duodenal bulb by endoscopy of upper gastrointestinal tract when these symptoms developed. The subjects of this study were 46 patients (male 22, female 24, mean age : $54.72{\pm}14.26$ years) who were chosen among ones who took oriental herb complex decoction for medical care and developed symptoms related to the gastrointestinal tract while taking an oriental herb decoction, which were assumed that the digestive symptoms were newly developed because of administration. The subjects were given morphological examination by endoscopy of the upper gastrointestinal tract. As a result of the endoscopy operated due to the digestive symptoms developed during the administration of oriental herb decoction, there were 2 cases of esophagitis, 5 cases of acute gastritis, 1 case of chronic gastritis A type, 15 cases of chronic gastritis B type, 1 case of duodenitis, 1 case of gastric ulcer, 1 case of gastric polyp, 2 cases of intestinal metaplasia, 1 case of gastric ptosis and 17 cases of normal findings which didn't have any abnormality macroscopically with endoscopy. With regards to the patients who complained of the digestive symptoms after taking oriental herb decoction, it has been found that the symptoms occurred as the oriental herbal medicine taken by the patients who had the digestive symptoms at ordinary times influenced on the gastrointestinal tract. Especially, many of them were had chronic gastritis and functional dyspepsia in the past. The disease accompanying macroscopic lesions at endoscopy which occurred due to the oriental herb decoction as direct cause, was acute gastritis, and it was the prescription to cure the pains and inflammations of skeletomuscular disease.

Comparison of Dietary Habit, Lifestyle, Health Attitude and Self-efficacy by Upper Gastrointestinal Disease among Group Mental Health Care Facilities with Chronic Schizophrenia (정신요양시설 만성조현병환자의 상부위장관질환 유무에 따른 식습관, 생활습관, 건강태도 및 자기효능감 비교연구)

  • Oh, Eun-Jung;Park, Keun-Young
    • Journal of Digital Convergence
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    • v.18 no.7
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    • pp.317-330
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    • 2020
  • The purpose of this study was to compare lifestyle, dietary habit, health attitude and self-efficacy among chronic schizophrenia with upper gastrointestinal disease and chronic schizophrenia to improve lifestyle, dietary habit and health attitude, in each mental health care facilities field, it was attempted to provide basic data to search for alternatives to increase self-efficacy. This study surveyed them from February 20th to April 30th in 2019 for data collection. Data were analyzed using Chi-square test, Independent t-test and ANCOVA with SPSS/WIN 22.0. The sociodemographic factor of age and education, the lifestyle factors of carbonated drink and physical activity intensity, the dietary habit factors of overeat, snack, late night meals and fatty food, the other factor of self-efficacy show statistically significant differences among groups. The study provides meaningful data in finding distinctive features of Upper Gastrointestinal Disease among Group with Chronic Schizophrenia. The results indicate that need to develope a variety of intervention methods to promote lifestyle and dietary habit and to enhance self-efficacy of chronic schizophrenia.

Epidemic Trends of Upper Gastrointestinal Tract Abnormalities: Hospital-based study on Endoscopic Data Evaluation

  • Mohiuddin, Mohammed Khaliq;Chowdavaram, Suman;Bogadi, Varun;Prabhakar, Boddu;Rao, Kondadasula Pandu Ranga;Devi, Suneetha;Mohan, Vasavi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5741-5747
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    • 2015
  • Purpose: To understand the epidemiology of different upper gastrointestinal (UGI) tract related abnormalities through endoscopic data analysis. Materials and Methods: A retrospective study of three years from January 2009 to December 2011 was conducted with data from endoscopic surveillance of upper GI tract problems, collected from the Gastroenterology Unit, Osmania General Hospital, Hyderabad. MS excel and Medcalc software (comparison of proportions) were used for data analysis. Results: A total of 10,029 (6,468 in males and 3,561 in females) endoscopies were performed during this three-year period. The male to female ratio was 1.8:1. Overall, ~30% of endoscopies evaluated showed patients with acid peptic disorders, 13.6% with vascular-related abnormalities, 10.6% showed structural abnormalities, followed by 6.3% with malignancies. Burden of malignancies was mostly observed in the older age group (60-69 years). Esophageal cancer cases decreased (p=0.0001) whereas stomach cancers increased over this period (p=0.0345). We also observed an increased incidence of acid peptic disease (APD) (p=0.0036) and gastroesophageal reflux disease (GERD) (p=0.0002) cases during this period. Conclusions: Endoscopic diagnosis is useful for early detection of UGI anomalies and helpful for physicians to manage and treat varied kinds of UGI disorders. Analysis of data revealed changing trends in the incidence of various pathologies of the UGI tract. Functional dyspepsia and GERD definitely reduce the quality of life of the individual. The role of our diverse dietary habits and lifestyle associated with these problems have not yet been established, though there have been reports on the effect of coffee, spicy food, wheat-based diet, screening of UGI pathologies along with collection of complete personal and medical history details, can h elp in correlating the patients' condition with various aspects of lifestyle and diet.

The impact of lymph node count on survival in gastric cancer

  • Ahn, Ha Rim;Han, Se Wung;Yang, Doo Hyun;Kim, Chan Young
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.120-127
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    • 2018
  • Purpose: The purpose of this study was to determine the immunologic role of lymph node (LN) and stage migration by assessing LN count and metastatic LN count. Methods: A total of 2,117 patients with gastric adenocarcinoma located in the body and antrum who underwent distal/subtotal gastrectomy with D2 LN dissection between January 1, 1998 and December 31, 2008 were enrolled. LN count and number of metastases were determined in the N1 tier (area of D1 dissection) and N2 tier (area of D2 dissection). The lower and upper quartiles of LN counts in the same pN stage were grouped to compare the prognosis and LN positivity according to the LN tier. Results: Stage migration from N1 tier to N2 tier occurred in 3.2% of cases. The 5-year disease-specific survival rates of the upper and lower LN count groups within the N1 tier were 91.0% and 86.7% (P=0.01), respectively. LN positivity in the N2 tier of the lower LN count group was higher than that of the upper LN count group (14.1% vs. 8.2%, P<0.01). Stage migration in the N2 tier of the lower LN count group was also higher than that of the upper LN count group (4.6% vs. 1.8%, P<0.01). Conclusion: The lower LN count group had a decreased survival rate compared to that of the upper LN count group, suggesting that perigastric LN has an immunological defense role in weakening the disseminating power of metastatic tumor cells, as indicated by the LN count.