title: Impact of esophagogastroduodenoscopy and ileocolonoscopy on diagnosis and therapy in patients with rheumatic diseases-a retrospective cohort study.
abstract: OBJECTIVE
  Many rheumatic diseases as well as their medications may cause gastrointestinal (GI) pathologies; in addition, some primary GI diseases may contribute or lead to rheumatic disease manifestations. The aim of this study is to analyze the clinical relevance of esophagogastroduodenoscopy (EGD) and ileocolonoscopy (IC) in patients suffering from inflammatory rheumatic diseases.
  
  
  METHODS
  A retrospective chart review was performed for all rheumatological inpatients who underwent EGD and/or IC within 2 years.
  
  
  RESULTS
  Within 2 years, 456 patients (261 female, 195 male) underwent 752 endoscopic investigations of the GI tract (419 EGDs and 333 ICs). Of all patients, 152 (33.3%) did not report any GI complaints. However, 28 of these asymptomatic patients (18.4%) suffered from esophagitis, a gastric ulcer could be identified in 20 patients (13%), whereas unspecific colitis was diagnosed in 19 patients (12.5%). In addition, 14 patients (9.2%) suffered from clinically unapparent Crohn's disease and two patients from Whipple's disease. In one patient with polymyalgia rheumatica, colon cancer was diagnosed. Altogether 304 patients reported GI complaints. Of these, 292 (39%) endoscopic investigations had impact on the final diagnosis or therapeutic strategy. The antirheumatic medication or the concomitant medication was changed in 18% of the patients due to the endoscopic findings; in 29 patients (6.5%) the initially clinically presumed diagnosis had to be corrected. In 70 patients (15%) with an undefined rheumatic diagnosis prior to endoscopy, endoscopic findings were decisive to establish the final diagnosis.
  
  
  CONCLUSIONS
  EGD and IC have a high diagnostic impact on patients with rheumatic diseases presenting with or without concomitant GI symptoms.
authors.affiliation: a Medical Centre for Rheumatology and Clinical Immunology , Immanuel Clinic Berlin-Buch , Berlin , Germany .
authors.forename: Valentin Sebastian
authors.initials: VS
authors.lastname: Schäfer
authors.affiliation: b Department of Rheumatology and Clinical Immunology , Asklepios Medical Center Bad Abbach , Bad Abbach , Germany , and.|c Department of Internal Medicine (I) , University Medical Center Regensburg , Regensburg , Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Fleck
authors.affiliation: b Department of Rheumatology and Clinical Immunology , Asklepios Medical Center Bad Abbach , Bad Abbach , Germany , and.
authors.forename: Boris
authors.initials: B
authors.lastname: Ehrenstein
authors.affiliation: b Department of Rheumatology and Clinical Immunology , Asklepios Medical Center Bad Abbach , Bad Abbach , Germany , and.
authors.forename: Ann-Kathrin
authors.initials: AK
authors.lastname: Peters
authors.affiliation: b Department of Rheumatology and Clinical Immunology , Asklepios Medical Center Bad Abbach , Bad Abbach , Germany , and.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartung
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D000066491:Clinical Decision-Making / Q000379:methods; D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data; D019468:Disease Management; D016145:Endoscopy, Digestive System / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000150:complications*; D063189:Symptom Assessment / Q000379:methods
keywords: Arthritis; Esophagogastroduodenoscopy; Gastrointestinal symptoms; Ileocolonoscopy; Rheumatic diseases