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Relationship between vomiting reflex during esophagogastroduodenoscopy and dyspepsia symptoms
Author(s) -
Enomoto Shotaro,
Watanabe Mika,
Yoshida Takeichi,
Mukoubayashi Chizu,
Moribata Kosaku,
Muraki Yosuke,
Shingaki Naoki,
Deguchi Hisanobu,
Ueda Kazuki,
Inoue Izumi,
Maekita Takao,
Iguchi Mikitaka,
Tamai Hideyuki,
Kato Jun,
Fujishiro Mitsuhiro,
Oka Masashi,
Mohara Osamu,
Ichinose Masao
Publication year - 2012
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2012.01241.x
Subject(s) - esophagogastroduodenoscopy , medicine , vomiting , reflex , gastroenterology , reflux , nausea , gerd , cough reflex , disease , endoscopy
Aim: Although frequent vomiting reflexes during esophagogastroduodenoscopy (EGD) causes suffering in patients, very few studies have investigated the characteristics of subjects who frequently develop vomiting reflexes. This study examined the incidence of the vomiting reflex and related factors, especially upper gastrointestinal symptoms, among individuals undergoing transoral EGD. Methods: Subjects included 488 consecutive adults (mean age, 56.1 ± 8.9 years) who underwent transoral EGD for gastric cancer screening between February 2010 and March 2011. All procedures were performed by an endoscopist with 15 years of experience. Based on a questionnaire survey using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), symptoms (dyspepsia and acid reflux symptoms) and the number of vomiting reflexes during EGD were recorded. Results: Of the 488 subjects, 271 (56%) developed vomiting reflexes (mean, 4.2 times). This reflex‐positive group was younger (54.3 ± 9.5 years) than the reflex‐negative group (58.3 ± 7.7 years, P < 0.001). The number of subjects in the reflex‐positive group with a high FSSG dyspepsia score (2.27 ± 2.57 vs 1.23 ± 1.84; P < 0.001), acid reflux symptom score (1.96 ± 2.22 vs 1.34 ± 2.14; P < 0.01) or an esophageal hiatal hernia (14.8% vs 4.6%; P < 0.001) was significantly higher than in the reflex‐negative group. Multivariate analysis also showed a significant correlation between these four factors and the occurrence of vomiting reflexes. Using an FSSG dyspepsia score of 1 as the cut‐off offered 68% sensitivity and 57% specificity for predicting the occurrence of vomiting reflexes. Conclusion: Based on FSSG questionnaire responses on upper gastrointestinal symptoms, dyspepsia symptoms, in particular, are related to presence of vomiting reflexes during EGD.