Prevalence of gastro-esophageal reflux in diabetic patients at a tertiary hospital in Central Saudi Arabia.

OBJECTIVES: To estimate the prevalence of gastro-esophageal reflux disease (GERD) among diabetic patients and to investigate GERD's potential association with diabetic complications, and patients' sociodemographic and clinical characteristics. METHODS: This cross-sectional study used the GERD questionnaire (GerdQ) in 403 diabetic patients attending the outpatient clinics at King Khalid University Hospital, King Saud University Medical City, King Saud University; a tertiary hospital in Riyadh, Saudi Arabia, between January and February 2019. On the basis of a cuto GerdQ score of 8, we distinguished GERD and non-GERD groups. RESULTS: Gastro-esophageal reflux disease prevalence was 44.9%. Of the diabetic patients with GERD, 76.8% were female (pless than 0.001). Gastro-esophageal re ux disease patients were older (mean age: 55.27, p=0.038) and had a slightly higher body mass index (BMI) than non-GERD (32.04 versus, 30.20 p=0.006), respectively. Smokers in the GERD group were 1.7% versus 7.2% in the non- GERD group (p=0.007). Peripheral numbness (p=0.023) and nephropathy (p=0.041) were more prevalent in patients with GERD, while myocardial infarction was more prevalent in non-GERD subjects (p=0.038). On multi variable analysis, the only independent GERD risk factors were female gender (p=0.013) and age more than 65 years (p=0.007). CONCLUSION: Gastro-esophageal reflux disease prevalence in diabetic patients was 45%. Diabetic patients with GERD were more often female and older than 65 years. None of the other tested factors (BMI, smoking status, diabetes mellitus duration, therapeutic plan, or diabetic complications) showed signi cant di erence between GERD and non-GERD groups.

Clinical and endoscopic significance of bowel-wall thickening reported on abdominal computed tomographies in symptomatic patients with no history of gastrointestinal disease.

BACKGROUND: Bowel-wall thickening (BWT) is a commonly reported finding on diagnostic abdominal pelvic computed tomographies (CT) in patients with no history of gastroenterologic disease. The significance of this nonspecific finding is not clear. METHODS: Medical records from the Vancouver General Hospital were reviewed from October 27, 1999, to October 27, 2009. The initial search yielded 5696 cases, of which 76 cases met the inclusion criteria for review. Inclusion criteria were the following: age older than 18 years, symptoms without a diagnosis of gastrointestinal disease before CT, the reported finding of terminal ileal and/or colonic BWT, colonoscopy after CT, and/or microbiologic investigations. Exclusion criteria included known gastrointestinal disease before CT. The primary objective was to determine if BWT could be associated with a significant endoscopic pathology. The secondary objective was to determine whether the pattern of abnormality on the CT was associated with a specific endoscopic finding. RESULTS: A total of 76 patients met the inclusion criteria of our study. Of those, 76% had various identifiable pathologies on colonoscopy. Only 24% had normal colonoscopic findings. Inflammatory bowel disease (IBD) and infectious colitis were the most common causes of BWT. A report of "skip lesions" on the CT (5%) was always associated with IBD. "Pancolitis" reported on the CT (11%) was associated with endoscopic findings of IBD in 25% of cases, infection in 50% of cases, and normal findings in 25% of cases. The report of "stranding" (36%) on CT in the presence of BWT was associated with many non-neoplastic endoscopic pathologic processes, including infectious colitis (22%), IBD (19%), and ischemia (15%), but also was associated with normal endoscopic findings in 26% of the cases. "Lymphadenopathy" was reported in 17% of the CTs and was associated with infectious colitis (30%), IBD (38%), or neoplastic processes (15%) but also normal endoscopic findings in 15%. CONCLUSION: Symptomatic patients who are found to have nonspecific BWT on CT should undergo definitive endoscopic investigation because the majority will have significant gastroenterologic disease, and only a minority will have a normal colonoscopy.

Patients awareness of their medical conditions in multi-specialty outpatient clinics in Saudi Arabia.

OBJECTIVE: To assess the patients awareness of their medical conditions, identify the factors affecting their awareness, and assess patient's satisfaction with their doctors explanations of medical conditions. METHODS: A cross-sectional study was conducted in October 2005 in the outpatient clinics of King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia. A self-administered questionnaire was used for data collection. The statistical package for Social Science was used for analysis. RESULTS: Five hundred and one patients were included in the study. The mean age was 45.6 +/- 16.8. Fifty-five percent were female and 29% were highly educated. Most of the patients (64.1%) knew their diagnoses. This was significantly associated with the educational level; chronicity of the disease, and the awareness of other issues related to their illness such as complications and name of their medications (p<0.05). Few patients (20%) knew complications of their diseases. Seventy percent of patients were satisfied with their doctors' explanation of their disease. Knowing the diagnosis (p=0.001) and the disease complications (p=0.014) were associated significantly with patients' satisfaction. CONCLUSION: These figures are less than what they should be. Physicians must be advised of the importance of proper patient education. In addition, the lack of proper education by physicians demonstrated in this study should be compensated for by an increase in non-physician based education tools.