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Do young dyspeptic patients consider upper gastro-intestinal endoscopy useful?
Per C Valle1, Ragnar K Breckan, Odd Kildahl-Andersen
1Department of Internal Medicine, University Hospital of North Norway, Harstad, 9480 Harstad, Norway. per.christian.valle@unn.no
Hepato-Gastroenterology
|March 18, 2011
Summary
Upper gastro-intestinal (GI) endoscopy is valuable for peptic ulcer disease but offers little reassurance for non-ulcer dyspepsia or gastroesophageal reflux disease patients. Treatment, not endoscopy findings, drives symptom improvement.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Patient Outcomes
Background:
- Selecting patients for upper gastro-intestinal (GI) endoscopy can optimize resource use.
- The impact of endoscopy findings and reassurance on patient improvement remains unevaluated.
Purpose of the Study:
- To assess the value of upper GI endoscopy in young dyspeptic patients.
- To determine the impact of endoscopy findings on symptom improvement and patient reassurance.
Main Methods:
- 280 young dyspeptic patients underwent upper GI endoscopy.
- Patients were classified into peptic ulcer disease, non-ulcer dyspepsia (NUD), or gastroesophageal reflux disease (GERD) groups.
- A one-year follow-up assessed symptom improvement and perceived reasons for it.
Main Results:
- 82% of peptic ulcer patients improved with eradication therapy.
- 63% of NUD patients improved, attributing it to lifestyle changes; only 16% cited endoscopy reassurance.
- GERD patients improved with acid-reducing medication; endoscopy findings were not key.
Conclusions:
- Upper GI endoscopy is most valuable for guiding therapy in peptic ulcer disease.
- Endoscopy reassurance in NUD and esophagitis detection in GERD do not significantly impact subjective improvement.
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