Investigation of upper gastrointestinal symptoms in patients with AIDS

Connolly, G M, Forbes, A, Gleeson, J A and Gazzard, B G (1989) Investigation of upper gastrointestinal symptoms in patients with AIDS. AIDS, 3 (7). pp. 453-6. ISSN 0269-9370

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Abstract

Double contrast barium radiology and upper gastrointestinal endoscopy were compared prospectively on 45 occasions in patients infected with HIV who presented with upper gastrointestinal symptoms. In 40 cases, a definite pathological diagnosis was reached and in four cases no organic basis for symptoms could be found. A correct and complete diagnosis was made on visual endoscopic criteria in 43 cases (95.5%) but in only 14 cases (31.1%) from barium studies alone. Radiology showed no abnormality in 22 cases where pathological changes were documented (oesophageal candidiasis in 21 cases). Where pathological confirmation of diagnosis existed (40 cases), endoscopy (without pathological support) had a sensitivity of 97.5% and a specificity of 100% compared with the sensitivity and specificity of 25 and 100% for barium studies. The difference between the sensitivities of the two methods was highly significant (P less than 0.005). The combination of oral candidiasis and upper gastrointestinal symptoms without dysphagia or weight loss was so strongly associated with uncomplicated oesophageal candidiasis (negative predictive value 93%; P less than 0.025), that this is supported as a basis for therapy without the need for further investigation, although if upper gastrointestinal investigation is required, endoscopy should be the method of choice.

Item Type: Article
Uncontrolled Keywords: acquired immunodeficiency syndrome,adolescent,adult,barium sulfate,body weight,candidiasis, oral,deglutition disorders,endoscopy,enema,female,gastrointestinal diseases,humans,male,middle aged
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 06 Aug 2014 11:40
Last Modified: 11 Apr 2019 15:40
URI: https://ueaeprints.uea.ac.uk/id/eprint/49517
DOI:

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