Trends and patterns of diagnosis by upper GI endoscopy in dyspeptic patients: A retrospective study

Background: Dyspepsia is described as recurrent upper abdominal discomfort and epigastric fullness after meals, often described by the patients as indigestion. The assessment of trending diagnostic patterns in upper GI endoscopy is important to validate the priority of endoscopic evaluation over other modalities of investigation for dyspepsia. The significant patterns may form a platform for new epidemiological studies to re-assess the risk factors and distribution of diseases causing dyspepsia in South Indian population. Aim: A retrospective study was done to assess the trends of diagnosis in upper GI endoscopy in adult dyspeptic patients in South Indian population. Materials and methods: Endoscopy database records of 3271 consecutive patients who underwent upper GI endoscopy between January 2014 and March 2016 were retrospectively analyzed from upper GI endoscopy register. The data was subjected to statistical analysis and compared with that of previous similar studies. Suspected malignant lesions were confirmed with histopathology reports. Results: Positive yield was 80.6%. Gastritis (51%), duodenitis (22%) and hiatus hernia (9%) were the leading endoscopy diagnoses. Esophageal growth was 3 times more common in females (p=0.009). Growth in stomach was reported in 2.3% patients. Carcinoma stomach was significantly higher in age above 40 years (p=0.0009). There was a positive correlation between Ca stomach and increasing age. The cumulative frequencies of gastric cancer by age group were as follows: 7 of 1000 OGDs in patients less than 40 years of age and 40 of 1000 OGDs in patients greater than 40 years of age. Conclusion: The results conclude that gastric malignancy is significantly higher in age>40 years. This recommends a routine upper GI endoscopy for patients>40 years. Esophageal growth is significantly higher in females warranting an epidemiological study on association with possibly dietary pattern and religion in these subjects. Frequent retrospective and prospective studies on yield of upper GI endoscopy are warranted to keep an early check on any alarming trends of significant diseases.