The Spectrum of Upper Gastrointestinal Endoscopic Findings and Therapeutic Interventions in Patients Presenting with Upper Gastrointestinal Complaints: A Tertiary Care Study

Abstract

Background: Endoscopy has a great role in the diagnosis, surveillance, and management of various gastrointestinal (GI) ailments. Aims: This study aimed to evaluate the spectrum of upper GI (UGI) symptoms and correlate them with the findings on UGI endoscopic examination. Patients and Methods: This observational cross‑sectional study was carried out from August 2019 to December 2020 in the adult patients presenting with UGI complaints. The patients underwent UGI endoscopy at Yenepoya Medical College Hospital, Mangalore, a tertiary care centre in southern Indian state of Karnataka. Endoscopies were performed as per the standard protocol with diagnosis based on accepted criteria. Results: A total of 450 subjects (mean age: 49.14 ± 13.9; range, 19–89; 322 [71.5%] men) were included. Among the diagnostic indications, dyspeptic symptom seen in 176 (39.1%) patients was the most frequent indication in this study cohort, followed by reflux in 73 (16.2%) patients, UGI bleeding in 69 (15.34%) patients (portal hypertensive bleeding was found to be more common than nonvariceal bleed (49:20). Antral gastritis was seen in 112 (24.9%) patients. Ninety (20%) patients were found to have esophageal varices and 47 (10.4%) had esophagitis. Biopsy showed 25.3% to be positive for Helicobacter pylori. Forty‑seven (10.45%) patients with a mean age 32 ± 6.8 years with dyspeptic symptoms but no alarming symptoms had normal endoscopic examination. Conclusion: Antral gastritis was the most common endoscopic finding in patients with dyspeptic symptoms. Portal hypertension was a more common cause of UGI bleeding compared to duodenal ulcers. While the majority of the patients presenting with heartburn had esophagitis, nonerosive esophagitis was observed in 3.2% of patients.