title: Cascade stomach is associated with upper gastrointestinal symptoms: a population-based study.
abstract: BACKGROUND
  Cascade stomach (CS) is recognized by characteristic findings on barium studies. We prospectively investigated the relationship between CS and upper gastrointestinal (GI) symptoms.
  
  
  METHODS
  In subjects undergoing health screening, CS was diagnosed by barium studies. Consecutive persons (500 men and 127 women) with CS were identified and the same number of age-matched subjects without CS were selected as controls. Upper GI symptoms were classified as reflux symptoms, dyspepsia symptoms, or epigastralgia symptoms. Then, we prospectively analyzed barium studies to classify the gastric morphology and also assessed upper GI symptoms in consecutive 5008 men and 2736 women.
  
  
  RESULTS
  BMI was significantly higher in men with CS than in controls, and also in women with CS than in controls. Upper GI symptoms were significantly more frequent in the CS group than the controls among both men and women, especially reflux symptoms. In men, logistic regression analysis identified CS as an independent risk factor for upper GI symptoms (odds ratio = 1.771, P = 0.005) and for reflux symptoms (odds ratio = 2.07, P = 0.009). In women, CS was also significantly related to upper GI symptoms (odds ratio = 2.544, P = 0.020). The prevalence of CS was significantly higher (P < 0.0001) among symptomatic men than among those with no symptoms.
  
  
  CONCLUSIONS
  Gastric morphology is related to upper GI symptoms in both men and women. Cascade stomach should be reconsidered as a pathophysiological factor associated with upper GI symptoms.
authors.affiliation: Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Maebashi, Gunma, Japan. mkusano@showa.gunma-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Kusano
authors.forename: H
authors.initials: H
authors.lastname: Hosaka
authors.forename: H
authors.initials: H
authors.lastname: Moki
authors.forename: Y
authors.initials: Y
authors.lastname: Shimoyama
authors.forename: O
authors.initials: O
authors.lastname: Kawamura
authors.forename: S
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: M
authors.initials: M
authors.lastname: Mori
authors.forename: M
authors.initials: M
authors.lastname: Akuzawa
mesh_terms: D015746:Abdominal Pain / Q000150:complications / Q000453:epidemiology; D000328:Adult; D001464:Barium; D015992:Body Mass Index; D003287:Contrast Media; D004415:Dyspepsia / Q000150:complications / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011153:Population; D011446:Prospective Studies; D012307:Risk Factors; D013270:Stomach / Q000033:anatomy & histology* / Q000473:pathology*; D013272:Stomach Diseases / Q000150:complications* / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D001464:Barium