Dispeptik semptomlarla beslenme aliskanliklari, endoskopik ve histolojik bulgular arasindaki iliski
The relationship between dyspeptic symptoms and feeding habits, endoscopic and histologic findings
- Ana Sayfa
- Sayılar
- Dispeptik semptomlarla beslenme aliskanliklari, endoskopik ve histolojik bulgular arasindaki iliski...
Özet
Giris ve amaç: Dispepsi, karin üst kisminda lokalize kronik agri yada rahatsizlik hissidir. Rahatsizlik hissi siskinlik ve erken doymayi içeren semptomlar kompleksinden olusur. Dispepsili hastalarin yaklasik olarak yarisi gidalar ile sikayetleri arasinda iliski kurarlar. Ayrica bazi gidalar, yag yada baharat tüketimi, alkol, sigara ve ilaç aliminin dispepsiyi indükledigine dair yaygin bir inanis vardir. Fakat yapilan çalismalarda dispeptik semptomlar ile gidalar arasinda iliski oldugu ispatlanamamistir. Çalismamizda, dispeptik yakinmasi olan hastalardaki endoskopik ve histopatolojik bulgular degerlendirildi. Bu bulgularin beslenme aliskanliklari ve semptomlar ile olan iliskisi arastirildi. Gereç ve yöntem: Çalismami za yas ortalamasi 39.04±10.4 yil (20-61) olan 100 hasta (42 erkek, 58 bayan) dahil edildi. Hastalar dispepsi semptomlari ve beslenme aliskanli klari yönünden sorgulandiktan sonra üst gastrointestinal sistem endoskopileri yapildi. Islem esnasinda tüm hastalardan uygun biyopsiler alindi ve histopatolojik inceleme yapildi. Bulgular: Hastalarimizin dispeptik sikayetleri sirasiyla epigastriumda agri (%91), epigastriumda açli k agrisi (%81), hazimsizlik, siskinlik, bulanti (%60), erken doyma (%56), postprandiyal agri (%39), ögürme (%30) ve kusma (%16) olarak tespit edildi. Epigastriumda agri ve açlik agrisinin, gastrit veya duodenal ülser ile olan iliskisi anlamliydi. (sirasiyla, p<0.01, p<0.05). Bulanti ile mide kanseri arasindaki iliski anlamliydi (p<0.01). Endoskopik görünümü normal olan 11 hastanin 3 tanesi histolojik olarak normal, 4 tanesi intestinal metaplazi ve 4 tanesinde kronik superficial gastrit tespit edildi. Semptomlar ile histopatolojik bulgular arasinda önemli iliski tespit edilmedi (p>0.05). Sonuç: Dispepsi semptomlari altta yatan etyolojiyi baki- mindan yol gösterici olabilir. Dispeptik hastalarda semptomlar endoskopi endikasyonunda yol gösterici olabilir. Dispepsi semptomlari ile histolojik bulgular arasinda iliskinin olmamasi nedeniyle, endoskopisinde organik bir neden tespit edilememis, ciddi dispeptik yakinmasi olan hastalarda histopatolojik taninin konulmasinin faydali olabilecegi, bu tür yaklasi min midenin prekanseröz lezyonlarinin tanisini kolaylastiracagi sonucuna varildi.
Abstract
Background/aim: Dyspepsia is defined as chronic pain or discomfort centered in the upper abdomen. Discomfort can incorporate a variety of symptoms including early satiety or upper abdominal fullness. Almost half of the patients with dyspepsia tend to make a relationship between foods and their symptoms. In addition, there is a widespread belief that the consumption of some specific foods, fatty or spicy, and the addition of alcohol, cigarette and drug intake can induce dyspepsia. However, the studies carried out do not support the relationship between dyspeptic symptoms and foods. In this study, the relationship between endoscopic and histopathologic findings and nutritional habit and symptoms of patients with the complaint of dyspepsia were investigated. Materials and methods: One hundred patients (42 males and 58 females, mean age 39.04±10.46 years, range 20-61) were included in the study. After the patients were questioned regarding dyspeptic symptoms and nutritional habits, upper gastrointestinal system endoscopies were performed. Biopsies were taken adequately from all patients and the biopsy samples were examined histopathologically. Results: Dyspeptic complaints of the patients were as follows: pain in epigastrium (91%), hunger pain in epigastrium (81%), indigestion, distention, nausea (60%), early satiety (56%), postprandial pain (39%), belching (30%) and vomiting (16%). A significant relationship was determined between gastritis or duodenal ulcer and epigastric pain and hunger pain (p<0.01, p<0.05 respectively). A significant relationship was also determined between belching and gastric cancer (p<0.01). Of 11 cases with normal endoscopic findings, 3 were histologically normal, 4 had intestinal metaplasia and 4 had chronic superficial gastritis. No significant relationship was found between symptoms and histopathologic findings (p>0.05). Conclusion: It was determined that dyspeptic symptoms were important because they may indicate an underlying etiology. Thus, endoscopy is indicated when investigating patient symptoms. There was no relation between dyspeptic symptoms and histologic findings. Thus, histopathologic diagnosis might be useful in patients with severe dyspeptic complaints but no organic cause according to endoscopy. It was concluded that the type of approach might facilitate the diagnosis of gastric precancerous lesions.
