Endoscopic Findings in Persistent Dyspepsia in Secondary Care Hospital Setting in North Kashmir

Dyspepsia is a common clinical problem and has a great impact on the patient's quality of life. More than half of patients presenting with dyspepsia have no detectable lesion for their symptoms. The common organic causes of dyspepsia include peptic ulcer, esophagitis and cancer. The diagnostic test of choice is endoscopy. Age specific thresholds to trigger endoscopic evaluation may differ by gender, availability of resources and regional disease specific risks.

The aim of the study was to determine the prevalence of significant endoscopic lesions in patients presenting with dyspepsia.

This was a retrospective study. Data on patients presenting with dyspepsia and scheduled for upper gastrointestinal (UGI) endoscopy between January 2011 and December 2016 was collected.

Nine thousand five hundred and twenty five patients with persistent dyspepsia were assessed by Upper GastroIntestinal (UGI) endoscopy. 58.8% were male. The mean age was 41 years. Endoscopy revealed normal findings or miscellaneous irrelevant findings in 6967 patients (73.1%). Significant endoscopic findings were diagnosed in 2558 (26.9%). These included peptic ulcers in 493 patients (5.1%), esophagitis in 560 (5.9%), erosive Gastroduodenitis in 1069 (11.2%), Varices in 40 patients (0.4%) and UGI malignancy in 279 (2.9%).

The endoscopic diagnosis of persistent dyspepsia in our setting showed a predominance of functional disease. Every 4th person (26.7%) with persistent dyspepsia had organic lesions whereas UGI malignancy was an uncommon finding. The most frequent significant pathologies included erosive gastroduodenitis, esophagitis and peptic ulcer disease. Patients with recent onset of dyspepsia who are in the age group at risk of gastric malignancy should undergo early endoscopy. UGI endoscopy is simple procedure that can be undertaken for early diagnosis of benign as well as malignant lesions in patient presenting with dyspepsia.