Value of upper gastrointestinal endoscopy in evaluating patients presenting with dyspepsia

Dyspepsia is a common symptom that is encountered in clinical practice and upper gastrointestinal endoscopy (UGIE) has gained wide acceptance in the evaluation of dyspepsia. This study was aimed to determine the yield of UGIE in patients presenting with dyspepsia to a tertiary care centre. Methods A retrospective analysis of patients followed up at a single unit in a tertiary care hospital from 2007 to 2016 was carried out. Patients who underwent UGIE for evaluation of dyspepsia were included in the study. Those with additional symptoms like dysphagia, loss of weight, loss of appetite and pancreato-biliary pathology were not included. The yield of UGIE in patients with dyspepsia (i.e.peptic ulcer, gastritis, polyp, cancer) in relation to two age groups (≤40years and >40 years) was determined and compared. Results A total of 491 patients were analysed (males=259, 52.7% ; mean age=46.65±SD21.93 years). Among them, 31.97 %(n=157) were aged 40 years or less. Abnormalities were detected in 01(61.3%) patients (peptic ulcer-2.44%, gastritis-20.4%, polyp-3.9%, endoscopically malignant lesions-3.2%). In the ≤40 age group, 58.6%(n=93) had positive endoscopic findings (i.e.peptic ulcer-1.2%, gastritis- 25.5%, polyp-1.2%, endoscopically malignant lesions-1.9%) while in the >40 year group, 62.6% had positive endoscopic findings (i.e.peptic ulcer-3.0%, gastritis-18.8%, polyp-5.1%, endoscopically malignant lesions-4.0%). Only two endoscopically malignant lesions were histologically malignant and both were detected in those who were aged more than 40 years. Conclusions In this study, the diagnostic yield of UGIE in detecting peptic ulcers, inflammatory and neoplastic lesions were considerably high in both age groups. Therefore, the age threshold for endoscopy may be lowered to avoid missing a significant lesion.