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Do young patients with dyspepsia need investigation?
B Williams1, M Luckas, J H Ellingham
1Leicester General Hospital.
Lancet (London, England)
|December 10, 1988
Summary
Young patients with simple dyspepsia are often overinvestigated. Most can be safely treated with antacids or histamine receptor type 2 antagonists, avoiding unnecessary endoscopy or barium meal examinations.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Clinical Medicine
Background:
- Simple dyspepsia is a common condition leading to investigations.
- Age is a significant factor in the diagnostic yield of dyspepsia investigations.
Purpose of the Study:
- To evaluate the necessity of endoscopy and barium meal examinations for patients with simple dyspepsia.
- To determine the diagnostic yield and incidence of malignancy in different age groups.
Main Methods:
- Retrospective analysis of 1386 patients undergoing endoscopy or double-contrast barium meal for dyspepsia in 1986.
- Analysis of malignant disorder incidence over a 6-year period (1980-1986) at endoscopy.
Main Results:
- Abnormal findings were more prevalent in older dyspeptic patients (58% endoscopy, 69% barium meal) compared to younger ones (40% endoscopy, 25% barium meal).
- Malignant disorders were diagnosed in 5% (endoscopy) and 3% (barium meal) of older patients, but not in any patient under 45.
- Only 1.8% of malignant disorders over 6 years occurred in patients under 45, all presenting with severe symptoms.
Conclusions:
- Young patients presenting with simple dyspepsia are frequently overinvestigated.
- Conservative management with antacids and/or histamine receptor type 2 antagonists is often sufficient for young patients with simple dyspepsia.