Correlation of Clinical, Endoscopic, and Pathological Findings among Suspected Peptic Ulcer Disease Patients in Abuja, Nigeria

Abstract

Background. Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims. To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods. This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t -test at 95% confidence intervals. Results. One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD ( p < 0.001 ) and abnormal endoscopic findings ( p < 0.001 ). No association was found between normal endoscopic findings and histological findings ( p = 0.924 ). Conclusion. There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.

Peptic ulcer disease among dyspeptic patients at endoscopy unit, University of Gondar hospital, Northwest Ethiopia

“…These findings were congruent with hospital-based sub-Saharan African (SSA) reports. The African reports verified that 40–65% of dyspeptic and 65–90% PUD patients were positive for H. pylori infection [ 7 , 8 , 19 , 20 , 23 , 24 ]. The Ethiopian pooled prevalence of H. pylori infection was 52.2% (95% CI 45.8–58.6) in a recent hospital-based meta-analysis [ 30 ].…”

“…Recent Nigerian study reported that gastritis/duodenitis (27%) and PUD (28%) were the frequently documented abnormal endoscopic findings. Gastric cancer (2.3%) was less frequently reported [ 7 ]. Studies in Tanzania and Ethiopia reported that gastritis/duodenitis (80–98%) followed by PUD (25–32%) were the commonly observed endoscopic pathologies.…”

“…The sample size was calculated using a single population proportion formula with the assumption of 95% confidence level, 5% margin of error, and taking a 25% estimated proportion of peptic ulcer disease among dyspeptic patients [ 7 , 8 ]. The sample size was determined for a study population size of 1000 during the study period.…”

“…Other less frequently implicated risk factors for PUD include genetics, stress, diet, smoking and alcohol [ 16 , 17 ]. Global reports indicated that H. pylori infection rate among PUD patients was 14–21% in the United States, 60–70% in Asia, and 70–90 in sub-Saharan Africa [ 4 , 5 , 7 , 18 – 23 ]. There was no recent document on H. pylori infection rate among PUD patients in Ethiopia.…”

Upper gastrointestinal bleeding in a Nigerian diagnostic center: a retrospective study of endoscopic records

“…This study's finding of UGIB being more common in males is consistent with that from several authors (2, 5-7). The male preponderance may be explained by the higher prevalence of the underlying diseases and risk factors in Nigerian males, namely alcohol, smoking, peptic ulcers, and chronic liver disease (12)(13)(14)(15). Thirty-three percent of the patients with UGIB in our study were at least 60 years.…”