Endoscopic evaluation of patients with dyspepsia in a tertiary care hospital in Sri Lanka

Introduction

Dyspepsia is a major cause of gastrointestinal (GI) system related morbidity in Sri Lanka. The aim of this study is to describe upper GI endoscopic findings and to explore the association between alarm features (AF) and upper GI malignancy in dyspeptic patients.

Methods

This is a cross-sectional study conducted on newly diagnosed dyspeptic patients in a general surgical unit of a tertiary care hospital from April 2014 to March 2015. Following the administration of a pre-tested interviewer-administered questionnaire, endoscopies were performed.

Results

A total of 111 endoscopies were performed. The male to female ratio was 1:1.05 and the mean age of the population was 50.7 years. Endoscopic findings consisted of normal gastric and duodenal mucosa (n=20, 18.0%), gastro-duodenal ulcers (n=04, 3.6%), erosive gastro-duodenitis (n=18, 16.2%), erythematous gastro-duodenitis (n=45, 40.5%), oesophagitis (n=06, 5.4%), hiatal hernia (n=09, 8.1%) and upper GI malignancy (n=09, 8.1%). The relationship between AF and malignancy was statistically significant (p<0.001). Sensitivity of AF was 89% and specificity was 88% in detecting malignancies.

Conclusion

Benign conditions of the upper GI tract accounts for dyspepsia in >90% of patients. AF seems to hold satisfactory validity as a screening tool for malignancies. Dyspeptic patients with AF should undergo early endoscopic study to exclude malignancy.

The Sri Lanka Journal of Surgery 2015; 33(4): 23-27