Correlation between the symptoms of upper gastrointestinal disease and endoscopy findings: Implications for clinical practice

Abstract

Objective Digestive symptoms are the most common complaints among patients who seek primary healthcare services. This study aims to identify digestive symptoms and determine their association with upper gastrointestinal endoscopy findings in patients treated at a public endoscopy centre in Northeast Brazil. Methods We conducted a cross-sectional study using data from 751 patients with digestive symptoms who had an indication for upper gastrointestinal endoscopy. We identified the association between these variables through Fisher's exact test or Chi-square test and calculated the odds ratio. Results Epigastric pain occurred in 83%, post-prandial plenitude in 72.6%, and heartburn in 72.3% of the patients. Women were more likely to present with epigastric pain ( p = 0.001; odds ratio [OR] = 1.25; confidence interval [CI] = 1.07–1.47), post-prandial plenitude ( p = 0.001; OR = 1.21; CI = 1.06–1.37), retrosternal pain or burning ( p = 0.03; OR = 1.11; CI = 1.004–1.24), heartburn ( p = 0.04; OR = 1.10; CI = 0.98–1.24), unintentional weight loss ( p = 0.01; OR = 1.12; CI = 1.02–1.24), and dysphagia ( p = 0.01; OR = 1.14; CI = 1.03–1.25). There was no statistically significant association between digestive symptoms and endoscopic findings of the upper gastrointestinal tract. Additionally, there was no significant association between digestive symptoms and abnormalities detected by endoscopy. Conclusion Dyspeptic symptoms of epigastric pain, post-prandial fullness, and heartburn were the most common symptoms in patients referred for endoscopy. Dyspepsia, heartburn, and dysphagia were more common in women than in men. Digestive symptoms were not associated with positive endoscopy findings or abnormalities detected by endoscopy.

Association between genetic polymorphisms of NOD1, Interleukin‐1B, and cagA strain with low‐grade duodenal eosinophilia in Helicobacter pylori‐related dyspepsia

“…65 We do not have a detailed explanation for this observation. However, similar observation was described in other studies in rural or low-resource area in Latin America like Brazil, 66 Mexico, 67 and Honduras. 68 Northeast Argentina can be categorized as a rural or low-resource area, where environmental factors may be associated with this observation.…”

“…The limitations of the study include (1) population studied: our cohort comprised of rural South-American population of H. pylorirelated functional dyspepsia with high proportion of EPS patients rather than PDS [66][67][68] ; (2) histological evaluation of duodenal samples from D2 only: we choose to evaluate D2 based on previous data where duodenal eosinophilia and degranulation was observed in FD subjects at D2 but not D1 when was compared with healthy controls 48,72 ; (3) our cohort comprised of 98 patients with H.…”

“…The limitations of the study include (1) population studied: our cohort comprised of rural South‐American population of H. pylori ‐related functional dyspepsia with high proportion of EPS patients rather than PDS 66–68 ; (2) histological evaluation of duodenal samples from D2 only: we choose to evaluate D2 based on previous data where duodenal eosinophilia and degranulation was observed in FD subjects at D2 but not D1 when was compared with healthy controls 48,72 ; (3) our cohort comprised of 98 patients with H. pylori‐ positive dyspepsia where sample size of some of the allele of NOD1 ‐796G>A (rs2075820) and IL‐1B ‐511C>T (rs16944) could be relatively small; therefore, multicenter studies with bigger sample size will be needed to support our results; and (4) psychological factors were not evaluated. Based on these limitations, the results may not apply to other referral centers with different ethnic backgrounds and more data are needed to confirm the associations observed here.…”

Development and validation of a scoring system to predict esophagogastroduodenoscopy necessity

“…Relying solely on symptomatic reports may inherently limit the predictive efficacy for specific diseases. 27 Second, certain conditions, such as functional gastrointestinal disorders 28 and non-erosive gastroesophageal reflux disease, 29 can manifest with GI symptoms without exhibiting abnormal EGD findings. This phenomenon can potentially influence the performance of the system by introducing false positivity.…”

“…First and foremost, accurate diagnosis of GI conditions often involves the integration of clinical symptoms and many laboratory and imaging examinations. Relying solely on symptomatic reports may inherently limit the predictive efficacy for specific diseases 27 . Second, certain conditions, such as functional gastrointestinal disorders 28 and non‐erosive gastroesophageal reflux disease, 29 can manifest with GI symptoms without exhibiting abnormal EGD findings.…”