Low Prevalence of Clinically Significant Endoscopic Findings in Outpatients with Dyspepsia

Abstract

Background. The value of endoscopy in dyspeptic patients is questionable. Aims. To examine the prevalence of significant endoscopic findings (SEFs) and the utility of alarm features and age in predicting SEFs in outpatients with dyspepsia. Methods. A retrospective analysis of outpatient adults who had endoscopy for dyspepsia. Demographic variables, alarm features, and endoscopic findings were recorded. We defined SEFs as peptic ulcer disease, erosive esophagitis, malignancy, stricture, or findings requiring specific therapy. Results. Of 650 patients included in the analysis, 51% had a normal endoscopy. The most common endoscopic abnormality was nonerosive gastritis (29.7%) followed by nonerosive duodenitis (7.2%) and LA-class A esophagitis (5.4%). Only 10.2% had a SEF. Five patients (0.8%) had malignancy. SEFs were more likely present in patients with alarm features (12.6% versus 5.4%, p = 0.004). Age ≥ 55 and presence of any alarm feature were associated with SEFs (aOR 1.8 and 2.3, resp.). Conclusion. Dyspeptic patients have low prevalence of SEF. The presence of any alarm feature and age ≥ 55 are associated with higher risk of SEF. Endoscopy in young patients with no alarm features has a low yield; these patients can be considered for nonendoscopic approach for diagnosis and management.

Endoscopic findings in patients with uninvestigated dyspepsia: A retrospective study from Qatar

“…We observed that epigastric pain was the most common presenting symptom (79.2%) in the overall study population, which is consistent with the ndings of previous study by Khaled et al who reported it as 76.6% [20], while it was reported as 34% in another study [24]. Our study revealed a higher prevalence of gastritis than other diseases (65.5%) which is higher than the past reported rates [20,22,24].…”

“…Thomson et al where they found malignancy only in 2 patients and both were above 50 years of age [24]. Similarly other studies also reported a low prevalence of malignancy 0.8% [20]. In our study the prevalence rates of gastric and duodenal ulcer were found to be 4.6 and 5.9 respectively.…”

“…The results of this study show a high prevalence of signi cant endoscopic ndings in subjects with dyspepsia. Signi cant endoscopic ndings were observed in 91.8% of study subjects which is higher than the previously reported rates [15,[19][20][21][22][23]. A study done by Thomson et al reported that 58% of patients having signi cant ndings on endoscopy [24].…”

“…In our study the prevalence rates of gastric and duodenal ulcer were found to be 4.6 and 5.9 respectively. The previous studies reported similar rates for gastric ulcer while the prevalence of duodenal ulcer showed a con icting results [20,22]. Mestan et al reported prevalence of gastric ulcer as 3.6% and that of duodenal ulcer 8.1%…”

Disminución en la frecuencia de infección por Helicobacter pylori en endoscopías digestivas altas

“…Esto fue confirmado también en nuestra serie: la úlcera gástrica (3,7%) fue más frecuente que la úlcera duodenal (2,7%), y sólo 51% de las úlceras gástricas y 46% de las úlceras duodenales fueron positivas para infección por HP, lo que puede deberse al mayor uso de antiinflamatorios no esteroidales. La baja frecuencia de úlcera péptica en nuestro centro es concordante con nuestra baja prevalencia de infección por HP (28,9%), lo que coincide con lo encontrado en otras series 26 . En contraste, en La Florida, Chile, con una prevalencia de infección por HP de 78%, se encontró mayor prevalencia de úlcera péptica, con 8,1% de pacientes con úlcera gástrica y 6,4% de pacientes con úlcera duodenal 3 .…”