The Prevalence of Barrett's Esophagus Among a Saudi Arabian Population.

BACKGROUND: While gastroesophageal reflux disease (GERD) is common in Middle Eastern countries, little data exists on the epidemiology of Barrett's esophagus (BE). AIMS: We aimed to determine the prevalence of BE among patients undergoing esophagogastroduodenoscopy (EGD) in a cohort of Saudi patients. METHODS: We retrospectively reviewed the endoscopy database at an academic tertiary care center. Consecutive adult patients who underwent an EGD for any indication between May 2014 and December 2018 were included. The prevalence of both endoscopically and histologically reported BE was determined. Multivariate regression analysis was used to identify factors associated with BE. RESULTS: A total of 2805 patients were included. The mean age was 48 years (± 18.6) and 38.7% were male patients. BE was reported endoscopically in 18 (0.64%) and confirmed histologically in 9 patients (0.32%). Among patients with endoscopically reported BE, the mean age was 50.3 (± 16.1) years and 13 (72.2%) were male patients. Of patients with BE, short-segment BE was reported in 14 (77.8%) patients. Among the 9 patients with histologically confirmed BE; only one patient had dysplastic BE. On univariate analysis, BE was associated with male gender (p < 0.01), but not with age > 50, hiatal hernia, obesity or EGD performed for GERD related indications. On multivariate regression analysis, male gender was the only factor associated with BE (aOR 3.77, 95% CI 1.39-11.97, p = 0.01). CONCLUSION: BE was endoscopically reported in 0.64% and histologically confirmed in 0.32% of this cohort of Saudi patients. Male gender was the only factor associated with BE.

Predictors of inadequate bowel preparation for inpatient colonoscopy.

BACKGROUND/AIMS: Adequate colonic cleansing is essential for achieving effective and safe colonoscopy. Inpatient status is one of several factors associated with poor bowel preparation leading to incomplete colonoscopy procedures, which in turn may cause increased patient morbidity, missed pathology, prolonged hospital stay, and increased cost. The aim of this study was to identify predictors of inadequate bowel preparation for inpatient colonoscopy. MATERIALS AND METHODS: Medical records of inpatients who underwent colonoscopy at a university hospital between January 2015 and June 2016 were reviewed. Logistic regression analysis was used to identify predictors of "inadequate" bowel preparation. Odds ratios (OR) with 95% confidence intervals (CI) were reported. RESULTS: We included 130 patients in the analysis with a mean age of 58.2 (17.3) years. Fifty-seven percent of the patients underwent the procedure before noon, and the remaining between noon and 4 pm. The most common indications for inpatient colonoscopies were gastrointestinal bleeding and screening for colorectal cancer, and the majority of patients received meperidine for sedation (38.5%). The overall bowel preparation success rate was 57%, and the success rate was higher in the morning procedures compared to the afternoon procedures (71% vs. 46%, p=0.004). Regression analysis identified procedure time as a significant predictor of bowel preparation success such that procedures performed in the afternoon had lower chances of success (OR=0.32, 95% CI=0.14-0.74, p=0.007). Aspirin use was also a positive predictor for bowel preparation success (OR=3.1, 95% CI=1.03-9.24, p=0.044). CONCLUSION: Incomplete colonoscopies for inpatients due to inadequate bowel preparation are very common. Procedures performed in the afternoon are less likely to be successful.