Dyspepsia: Should all patients undergo endoscopy?

The role of endoscopy in the diagnosis of dyspepsia is not clear and there are conflicting reports mainly from western countries.

All patients presenting with dyspepsia to the gastroenterology department of the M.L.N. Medical College, Allahabad, between January 1989 and April 1990, were subjected to endoscopy. Patients were divided into two age groups: younger (≤45 years) and older (>45 years).

Ninety-two (16%) of 567 patients in the younger age group had endoscopic abnormalities and the majority had minor diseases such as peptic ulcer whereas 69 (42%) of 165 patients in the older age group had abnormalities (p<0.001)and 15(9%) had gastric carcinomas.

We suggest that in cases of dyspepsia, only patients above the age of 45 years should be subjected to routine endoscopy. This will considerably reduce the load on endoscopy units and make the procedure more costeffective.