Endoscopic evaluation of patients with dyspepsia in a secondary referral hospital in Egypt
Background: Dyspepsia is a common clinical problem. More than half of patients presenting with dyspepsia have no detectable lesion for their symptoms. The common organic causes of dyspepsia include peptic ulcer, esophagitis and cancer. The diagnostic test of choice is endoscopy. Age specific thresholds to trigger endoscopic evaluation may differ by gender, availability of resources and regional disease specific risks.
Aim: The aim of the study was to determine the prevalence of significant endoscopic lesions in Egyptian patients presenting with dyspepsia in relation to age.
Materials and methods: This was a retrospective study. Data on patients presenting with dyspepsia and scheduled for upper gastrointestinal (UGI) endoscopy between January 2000 and January 2013 were collected.
Results: One thousand four hundred patients with dyspepsia (31% of all endoscopies) were assessed by UGI endoscopy. Fifty-one percent were male. The mean age was 43 ± 15 years. Four hundred and fifty patients (32%) had a history of smoking, 388 (32%) were taking aspirin or non-steroidal anti-inflammatory drugs and 22 (2%) were consuming alcohol. Endoscopy revealed normal findings or miscellaneous irrelevant findings in 913 patients (65%). Significant endoscopic findings were diagnosed in 487 (35%). These included peptic ulcers in 245 patients (18%), esophagitis in 191 (14%), erosive gastroduodenitis in 112 (8%) and UGI malignancy in 16 (1%). Significant endoscopic findings were associated with increasing age.
Conclusion: Dyspepsia is a common indication for endoscopy in Egypt. Endoscopy revealed normal findings or miscellaneous irrelevant findings in the majority of patients. The most frequent significant pathologies included peptic ulcer, esophagitis and erosive gastroduodenitis. These were associated with increasing age. UGI malignancy was uncommon and found in older age groups.