Dyspepsia with alarm symptoms in patients aged less than 60 years: Is upper gastrointestinal endoscopy justified in Indian scenario?

Kumari, Priya; Machhan, Prem; Sharma, Brij; Sharma, Rajesh; Bodh, Vishal; Kumar, Rajesh

doi:10.1007/s12664-022-01275-y

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…The authors concluded that the optimal age to begin screening for malignancy in dyspepsia patients in India seems to be 46.5 years [89]. In another recent study from northern India on 294 patients with dyspepsia, the authors found that even among patients younger than 60 years with alarm features, a considerable number of patients had organic lesions (65%) including malignancy (16%) on upper GI endoscopy [90]. These authors chose a cut-off value of 60 years for age as the American College of Gastroenterology (ACG) and Canadian Association of Gastroenterology (CAG) guidelines did not recommend upper GI endoscopy to investigate alarm features for dyspepsia patients under the age of 60 to exclude upper GI malignancy [91].…”

Section: Voting Summary: Accepted Completely: (100%)mentioning

confidence: 99%

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Ghoshal

Sachdeva

Pratap

et al. 2023

Indian J Gastroenterol

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The Indian Neurogastroenterology and Motility Association (INMA), earlier named the Indian Motility and Functional Diseases Association developed this evidence-based practice guidelines for the management of irritable bowel syndrome (IBS). A modified Delphi process was used to develop this consensus containing 28 statements, which were concerning diagnostic criteria, epidemiology, etiopathogenesis and comorbidities, investigations, lifestyle modifications and treatments. Owing to the Coronavirus disease-19 (COVID-19) pandemic, lockdowns and mobility restrictions, web-based meetings and electronic voting were the major tools used to develop this consensus. A statement was regarded as accepted when the sum of “completely accepted” and “accepted with minor reservation” voted responses were 80% or higher. Finally, the consensus was achieved on all 28 statements. The consensus team members are of the view that this work may find use in teaching, patient care, and research on IBS in India and other nations.

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Section: Voting Summary: Accepted Completely: (100%)mentioning

confidence: 99%

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Ghoshal

Sachdeva

Pratap

et al. 2023

Indian J Gastroenterol

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“…By contrast, statins which were our sample’s most used medications reported in 191 patients of 605 (32%), were not linked to SEFs. Moreover, a previous study suggested a protective role against endoscopic lesions, especially in aspirin consumers or patients with cardiovascular diseases, which might also explain the lack of correlation between our sample’s aspirin users and SEFs[ 22 ].…”

Section: Discussionmentioning

confidence: 95%

Yield of alarm features in predicting significant endoscopic findings among hospitalized patients with dyspepsia

Ibrahim,

Basheer,

Khoury

et al. 2024

World J Gastroenterol

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BACKGROUND Dyspepsia is a very prevalent upper gastrointestinal tract symptoms complex. Some of these symptoms might arise from serious underlying diseases, so the promotion of evidence-based guidelines could potentially better align evaluation and treatment. AIM To determine the value of alarm features as a predictive factor for significant endoscopic findings (SEFs) among hospitalized patients presenting with dyspepsia. METHODS We conducted a retrospective case-control study including information about 6208 endoscopic procedures performed for hospitalized patients. Patients were divided into two groups, with and without SEFs, and compared to elucidate the ability of the different alarm features to predict SEFs. RESULTS During the study, 605 patients fulfilled the inclusion criteria. When the demographics and clinical characteristics of the two groups were compared, tachycardia (P < 0.05), normocytic anemia, (P < 0.05), leukocytosis (P < 0.05), and hypoalbuminemia (P < 0.05) documented on admission prior to endoscopy were strong predictors of SEFs. Among the alarm features, upper gastrointestinal bleeding, persistent vomiting, odynophagia [odds ratio (OR) = 3.81, P < 0.05; OR = 1.75, P = 0.03; and OR = 7.81, P = 0.07, respectively] were associated with SEFs. Unexplained weight loss was strongly associated with malignancy as an endoscopic finding (OR = 2.05; P < 0.05). In addition, long-term use of anti-aggregate medications other than aspirin (P < 0.05) was correlated to SEFs. CONCLUSION Novel predictors of SEFs were elucidated in this study. These parameters could be used as an adjunctive in decision making regarding performing upper endoscopy in hospitalized patients with dyspepsia.

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Editorial commentary on the Indian Journal of Gastroenterology —September–October 2022

Limdi

2022

Indian J Gastroenterol

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Dyspepsia with alarm symptoms in patients aged less than 60 years: Is upper gastrointestinal endoscopy justified in Indian scenario?

Cited by 4 publications

References 33 publications

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Yield of alarm features in predicting significant endoscopic findings among hospitalized patients with dyspepsia

Editorial commentary on the Indian Journal of Gastroenterology —September–October 2022

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