UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS IN PATIENTS REFERRED WITH UPPER GASTROINTESTINAL SYMPTOMS IN ELDORET,...

Area of Science:

• Gastroenterology
• Endoscopic Diagnostics
• Public Health in Resource-Constrained Settings

Background:

• Dyspepsia is a primary indication for upper gastrointestinal endoscopy, alongside other symptoms like dysphagia and bleeding.
• Upper gastrointestinal endoscopy is a costly procedure, limiting access in resource-limited regions like western Kenya.
• A review of endoscopy records from local health institutions was conducted to understand referral patterns and diagnoses.

Purpose of the Study:

• To determine the referral patterns and endoscopy diagnoses for patients undergoing upper gastrointestinal endoscopy in Eldoret, Kenya.
• To analyze the relationship between presenting symptoms and endoscopic findings in this population.

Main Methods:

• A retrospective chart review of 1690 patients who underwent upper GI endoscopy between 1993 and 2003.
• Data collected included patient demographics, symptoms, and endoscopic diagnoses.
• Statistical analysis was performed on the extracted information.

Main Results:

• Dyspepsia was the most frequent symptom (62.7%), followed by dysphagia (13.3%).
• The most common endoscopic diagnoses were esophageal cancer (11.8%) and duodenal ulcer (11.0%).
• A significant proportion (30.4%) of patients had normal endoscopy findings, including a majority of those presenting with dyspepsia.

Conclusions:

• While dyspepsia is the main referral reason, most patients show normal endoscopic results.
• Esophageal cancer was the primary diagnosis for patients with dysphagia.
• Given the cost, selective referral for upper gastrointestinal endoscopy, particularly for dyspepsia with alarm symptoms, is recommended.