Outcome of Index Upper Gastrointestinal Endoscopy in Patients Presenting with Dyspepsia in a Tertiary Care Hospital

Background: Dyspepsia is a common symptom seen in clinical practice. It is necessary to differentiate between functional and organic dyspepsia as peptic ulcers and gastrointestinal (GI) malignancy are increasing in incidence. Objective: In this study, the outcome of index upper gastrointestinal (UGI) endoscopy in patients with dyspeptic symptoms was evaluated prospectively. Materials and Methods: Between December 2011 and December 2012, 500 consecutive dyspeptic outpatients underwent prospective evaluation with a standardized questionnaire and then UGI endoscopy. Data were analyzed to see the number and frequency of abnormal findings in UGI tract and their significance in relation to the presenting symptoms. Endoscopic findings were defined as important if lesions seen were gastric or duodenal ulcers, moderate to severe gastritis, severe esophagitis, adenomatous polyps or cancer. Histological examination results were obtained for patients who underwent endoscopic biopsy. Results: The mean age of patients was 40 years. Dyspeptic symptoms were more common in 21-40 years age group. No important finding was found in 168 patients, and 433 pathologies were detected in the remaining 332 patients, of which 321 patients had benign findings and 11 patients showed findings suggestive of malignancy. Multiple pathologies were seen in 86 patients and found to be more among males. Reflux esophagitis (17%), erythematous gastritis (18%) and erosive duodenitis (6%) were the common findings. Conclusion: Erythematous gastritis followed by reflux esophagitis, was the most common endoscopic abnormality. The yield of important findings in index UGI endoscopy was statistically significant in patients who presented with dyspepsia.