scholarly journals Diagnostic yield of esophagogastroduodenoscopy, colonoscopy, and small bowel endoscopy in Thai adults with chronic diarrhea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julajak Limsrivilai ◽  
Choompunuj Sakjirapapong ◽  
Onuma Sattayalertyanyong ◽  
Tanawat Geeratragool ◽  
Phalat Sathirawich ◽  
...  
Keyword(s):  
Weight Loss ◽  
Small Bowel ◽  
Medical Records ◽  
Gastrointestinal Endoscopy ◽  
Chronic Diarrhea ◽  
Diagnostic Yield ◽  
Significant Weight Loss ◽  
Push Enteroscopy ◽  
The Mean ◽  
Small Bowel Endoscopy

Abstract Background Gastrointestinal endoscopy is frequently recommended for chronic diarrhea assessment in Western countries, but its benefit in the Southeast Asia region is not well established. Methods Medical records of consecutive patients undergoing esophagogastroduodenoscopy (EGD), colonoscopy, and small bowel endoscopy for chronic diarrhea from 2008 to 2018 were reviewed. Small bowel endoscopy included push enteroscopy, balloon-assisted enteroscopy (BAE), and video capsule endoscopy (VCE). The diagnostic yield of each endoscopic modality and predictors for positive small bowel endoscopy were analyzed. Results A total of 550 patients were included. The mean age was 54 years, and 266 (46.3%) patients were male. The mean hemoglobin and albumin levels were 11.6 g/dL and 3.6 g/dL, respectively. EGD and colonoscopy were performed in 302 and 547 patients, respectively, and the diagnostic yield was 24/302 (7.9%) for EGD and 219/547 (40.0%) for colonoscopy. EGD did not reveal positive findings in any patients with normal colonoscopy. Fifty-one patients with normal EGD and colonoscopy underwent small bowel endoscopy. Push enteroscopy, BAE, and VCE were performed in 28, 21, and 19 patients with a diagnostic yield of 5/28 (17.9%), 14/21 (66.7%), and 8/19 (42.1%), respectively. Significant weight loss, edema, and hypoalbuminemia were independent predictors for the positive yield of small bowel endoscopy. Conclusion Colonoscopy was an essential diagnostic tool in identifying the cause of chronic diarrhea in Thai patients, whereas EGD provided some benefits. Small bowel endoscopy should be performed when colonoscopy and EGD were negative, particularly in patients with significant weight loss, edema, and hypoalbuminemia.

Diagnostic Performance of Esophagogastroduodenoscopy, Colonoscopy, and Small Bowel Endoscopy in Thai Adults with Chronic Diarrhea

2021 ◽  
Author(s):  
Julajak Limsrivilai ◽  
Choompunuj Sakjirapapong ◽  
Ananya Pongpaibul ◽  
Piyaporn Apisarnthanarak ◽  
Phutthaphorn Phaophu ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Medical Records ◽  
Diagnostic Performance ◽  
Gastrointestinal Endoscopy ◽  
Chronic Diarrhea ◽  
Diagnostic Yield ◽  
Diagnostic Utility ◽  
Push Enteroscopy ◽  
Small Bowel Endoscopy

Abstract Background: Gastrointestinal endoscopy is recommended to investigate chronic diarrhea in Western countries, but its benefits have infrequently been investigated in Southeast Asia. This study aimed to determine the diagnostic utility of esophagogastroduodenoscopy (EGD), colonoscopy, and small bowel endoscopy in Thai chronic diarrhea. Methods: Medical records of consecutive patients who underwent EGD and/or colonoscopy to investigate chronic diarrhea at our center from 2008 to 2012 were reviewed. We also evaluated consecutive patients with negative EGD and colonoscopy who underwent subsequent small bowel endoscopy, including push enteroscopy, balloon-assisted enteroscopy (BAE), and video capsule endoscopy (VCE), from 2008 to 2018. The diagnostic yield of each endoscopic modality was analyzed. Results: A total of 272 patients underwent EGD and/or colonoscopy. Mean hemoglobin and albumin levels were 11.6 g/dL and 3.8 g/dL, respectively. EGD and colonoscopy were performed in 135 and 269 patients, respectively, and the diagnostic yield was 5.9% for EGD and 42.7% for colonoscopy. No patient with normal colonoscopy had positive EGD findings. Thirty-nine patients with normal EGD and colonoscopy underwent small bowel endoscopy. Mean hemoglobin and albumin levels were 10.9 and 2.7 g/dL, respectively. Push enteroscopy, BAE, and VCE were performed in 22, 20, and 11 patients with a diagnostic yield of 22.7%, 60.0%, and 45.5%, respectively. Conclusion: Colonoscopy was shown to be an essential investigation in chronic diarrhea. In contrast to western, EGD did not add benefit to colonoscopy. Enteroscopy played an important role in the diagnosis of chronic diarrhea when colonoscopy was negative.

scholarly journals Colonic Abnormalities in Manitoban Children with Helicobacter pylori Gastritis

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Upama Banik ◽  
Camelia Stefanovici ◽  
Jennifer Griffin ◽  
Wael El-Matary
Keyword(s):  
Weight Loss ◽  
Helicobacter Pylori ◽  
Retrospective Review ◽  
Medical Records ◽  
Significant Weight Loss ◽  
Endoscopic Findings ◽  
Bleeding Per Rectum ◽  
The Mean ◽  
H Pylori ◽  
Helicobacter Pylori Gastritis

Objectives. Association between Helicobacter pylori (H. pylori) and colonic pathology is underinvestigated. The aim of this work was to examine the prevalence and nature of colonic changes in children diagnosed with H. pylori gastritis. Methods. A comprehensive retrospective review of the medical records for all Manitoban children (≤17 years) diagnosed with H. pylori gastritis from January 1996 to May 2015 was conducted. Children with H. pylori gastritis who had colonoscopy were identified. Patients’ demographics, indications for colonoscopy, laboratory and endoscopic findings, and colonic histopathological abnormalities were documented. Results. A total of 231 children were found to have H. pylori gastritis. The mean age at diagnosis was 12.3 ± 4.1 years; 108 (46.6%) were girls. Of the 231 patients, 37 (16%) patients were found to have colonoscopy performed. Indications for colonoscopy included bleeding per rectum, significant weight loss, and hypoalbuminemia. Twenty-two (59%) of 37 children who had colonoscopy had significant endoscopic and histopathological findings on colonoscopy including polyposis and colitis. Boys with colonic changes were diagnosed at an earlier age compared to those without (11.5 ± 7.0 versus 15.0 ± 2.0, p<0.049). Conclusions. Our study may suggest a possible association between H. pylori and a subset of colonic changes in children.

scholarly journals Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Endoscopy ◽  
2019 ◽  
Vol 51 (06) ◽  
pp. 574-598 ◽  
Author(s):  
Cristiano Spada ◽  
Deirdre McNamara ◽  
Edward J. Despott ◽  
Samuel Adler ◽  
Brooks D. Cash ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Small Bowel ◽  
Performance Measures ◽  
Capsule Endoscopy ◽  
European Society ◽  
Gastrointestinal Endoscopy ◽  
Quality Improvement Initiative ◽  
Upper Gastrointestinal Endoscopy ◽  
Small Bowel Endoscopy ◽  
First Time

AbstractThe European Society of Gastrointestinal Endoscopy (ESGE) together with the United European Gastroenterology (UEG) recently developed a short list of performance measures for small-bowel endoscopy (i. e. small-bowel capsule endoscopy and device-assisted enteroscopy) with the final goal of providing endoscopy services across Europe with a tool for quality improvement. Six key performance measures for both small-bowel capsule endoscopy and for device-assisted enteroscopy were selected for inclusion, with the intention being that practice at both a service and endoscopist level should be evaluated against them. Other performance measures were considered to be less relevant, based on an assessment of their overall importance, scientific acceptability, and feasibility. Unlike lower and upper gastrointestinal endoscopy, where performance measures had already been identified, this is the first time that small-bowel endoscopy quality measures have been proposed.

scholarly journals Optimising the use of small bowel endoscopy: a practical guide

2019 ◽  
Vol 10 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Stefania Chetcuti Zammit ◽  
David S Sanders ◽  
Mark E McAlindon ◽  
Reena Sidhu
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Concise Review ◽  
Small Bowel Tumours ◽  
Line Test ◽  
Meta Analyses ◽  
Small Bowel Endoscopy ◽  
Bowel Imaging ◽  
Small Bowel Bleeding

The wireless nature of capsule endoscopy offers patients the least invasive option for small bowel investigation. It is now the first-line test for suspected small bowel bleeding. Furthermore meta-analyses suggest that capsule endoscopy outperforms small bowel imaging for small bowel tumours and is equivalent to CT enterography and magnetic resonance enterography for small bowel Crohn’s disease. A positive capsule endoscopy lends a higher diagnostic yield with device-assisted enteroscopy. Device-assisted enteroscopy allows for the application of therapeutics to bleeding points, obtain histology of lesions seen, tattoo lesions for surgical resection or undertake polypectomy. It is however mainly reserved for therapeutics due to its invasive nature. Device-assisted enteroscopy has largely replaced intraoperative enteroscopy. The use of both modalities is discussed in detail for each indication. Current available guidelines are compared to provide a concise review.

scholarly journals Role of Small Bowel Endoscopy in Diagnosis and Management of Inflammatory Bowel Disease: Current Perspective

2021 ◽  
Author(s):  
Partha Pal ◽  
D. Nageshwar Reddy ◽  
Zaheer Nabi
Keyword(s):  
Inflammatory Bowel Disease ◽  
Small Bowel ◽  
Bowel Disease ◽  
Radiological Imaging ◽  
Push Enteroscopy ◽  
Balloon Enteroscopy ◽  
Inflammatory Bowel ◽  
Spiral Enteroscopy ◽  
Single Balloon ◽  
Small Bowel Endoscopy

The evaluation of small bowel in inflammatory bowel disease (IBD) is mainly performed in cases with newly diagnosed or suspected Crohn’s disease (CD). The available modalities for small bowel evaluation include radiological imaging (barium meal follow through, magnetic resonance enteroclysis, computed tomography enteroclysis) and small bowel endoscopy also known as enteroscopy. The main advantage of small bowel endoscopy over radiological imaging is that it allows for obtaining biopsy specimen required for histological confirmation of the diagnosis. Various endoscopic modalities for endoscopic evaluation of small bowel include push enteroscopy and device assisted enteroscopy (DAE). Push enteroscopy allows only limited evaluation of proximal small bowel. Therefore, DAE is generally preferred over push enteroscopy for small bowel evaluation. DAE includes single balloon enteroscopy, double balloon enteroscopy, and spiral enteroscopy. The available literature suggests that there is no significant difference in the diagnostic yield among the available DAE devices. Therefore, the choice of DAE is largely dependent on the availability as well as local expertise. More recently, motorised spiral enteroscopy has been introduced. The main advantage of this novel DAE is ease of use with the possibility of evaluating the entire small bowel via per-oral route. However, the data regarding the use of motorised spiral enteroscopy is limited and comparative trials are required in future.

scholarly journals An 11-year-old boy with chronic diarrhea and weight loss

2020 ◽  
Vol 13 (1) ◽  
pp. 35-41
Author(s):  
Maimuna Sayeed ◽  
Nazmul Hassan ◽  
Md. Rukunuzzaman ◽  
Bishnu Pada Dey
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Fecal Incontinence ◽  
Small Volume ◽  
Chronic Diarrhea ◽  
Significant Weight Loss ◽  
History Of

This article has no abstract. The first 100 words appear below: An 11-year-old boy presented with 15 months history of diarrhea with up to 10-20 times small volume stool daily with mucus. It was associated with a feeling of incomplete defecation and excessive straining. The frequency of diarrhea increased to 20-30 times per day over the last 8 months. Subsequently, he developed fecal incontinence, for which he couldn't attend his school. He also had a history of significant weight loss in the last 7 months. According to his mother's statement, his body weight was reduced to 64 kg from 77 kg during this illness.

scholarly journals Capsule endoscopy in clinical practice: four years of experience from a single center

2011 ◽  
Vol 48 (3) ◽  
pp. 220-222 ◽  
Author(s):  
Gustavo Pignaton de Freitas ◽  
Newton Teixeira ◽  
Gregorio Feldman
Keyword(s):  
Capsule Endoscopy ◽  
Medical Records ◽  
Diagnostic Method ◽  
Chronic Diarrhea ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
Single Center ◽  
Chronic Anemia ◽  
High Diagnostic Yield ◽  
Obscure Bleeding

Capsule endoscopy is a diagnostic method of increasing use nowadays, with various applications such as, evaluation of obscure gastrointestinal bleeding, chronic diarrhea and anemia. The experience of 4 years is reported in a retrospective review of 109 medical records to determine the main indications and the most common diagnostic findings and the percentage of positive studies. The main indications were obscure bleeding in 65%, chronic anemia in 8%. Vascular lesions in 33%, being that, hematocistic spot was found in 53% of studies. The location of active bleeding was possible in five patients (4.5%). Capsule endoscopy shows a high diagnostic yield in obscure bleeding.

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