Low Prevalence of Clinically Significant Endoscopic Findings in Outpatients with Dyspepsia

• Type of Material: Article
• Authors: Khaled Abdeljawad, Emory University School of Medicine; Antonios Wehbeh, Emory University School of Medicine; Emad Qayed, Emory University
• Language: English
• Date: 2017
• Publisher: Hindawi Publishing Corporation
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Khaled Abdeljawad et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1155/2017/3543681
• Title of Journal or Parent Work: Gastroenterology Research and Practice
• ISSN: 1687-6121
• Volume: 2017
• Start Page: 1
• End Page: 7
• Keywords: nonerosive gastritis; endoscopy; dyspepsia; significant endoscopic findings
• Research Categories: Health Sciences, General

Abstract

Background. The value of endoscopy in dyspeptic patients is questionable. Aims. To examine the prevalence of significant endoscopic findings (SEFs) and the utility of alarm features and age in predicting SEFs in outpatients with dyspepsia. Methods. A retrospective analysis of outpatient adults who had endoscopy for dyspepsia. Demographic variables, alarm features, and endoscopic findings were recorded. We defined SEFs as peptic ulcer disease, erosive esophagitis, malignancy, stricture, or findings requiring specific therapy. Results. Of 650 patients included in the analysis, 51% had a normal endoscopy. The most common endoscopic abnormality was nonerosive gastritis (29.7%) followed by nonerosive duodenitis (7.2%) and LA-class A esophagitis (5.4%). Only 10.2% had a SEF. Five patients (0.8%) had malignancy. SEFs were more likely present in patients with alarm features (12.6% versus 5.4%, p = 0.004). Age ≥ 55 and presence of any alarm feature were associated with SEFs (aOR 1.8 and 2.3, resp.). Conclusion. Dyspeptic patients have low prevalence of SEF. The presence of any alarm feature and age ≥ 55 are associated with higher risk of SEF. Endoscopy in young patients with no alarm features has a low yield; these patients can be considered for nonendoscopic approach for diagnosis and management.