The changing prevalence of upper gastrointestinal endoscopic diagnoses: a single-centre study

Upper gastrointestinal (GI) endoscopy is increasingly applied in daily practice. Not many data are available on yearly changes in diagnostic yield, nor on changes in morbidity.

To study the possible changes in occurrence of abnormalities in the oesophagus, stomach and duodenum.

All consecutive upper GI endoscopies performed over a period of 20 years were included. Important diagnoses were defined as: oesophagitis, metaplastic epithelium in the oesophagus, hiatal hernia or defective sphincter, ulcers, erosive or nodular gastritis, operated stomach, and cancer.

In the 20-year period, 29,218 upper GI endoscopies were performed. 'Open-access' endoscopy, i.e. at the request of the general practitioner, showed a clear increase in the first ten years and remained stable thereafter. A trend towards an increase in macroscopic abnormalities was seen. The presence of hiatal hernia and defective sphincter showed a significant increase over 20 years, while the number of patients with reflux oesophagitis showed a less impressive, but still significant increase (p<0.001) in the first ten years and remained stable thereafter. There was an impressive decrease in the incidence of peptic ulcer disease. Prevalence of oesophageal cancer showed a gradual increase, although the numbers were very low.

In a period of 20 years the diagnostic yield of upper GI endoscopy showed significant changes. Reflux disease increased in prevalence while peptic ulcer disease decreased.