Saravanakumar, S (2014) A clinical study of various findings in upper gastrointestinal endoscopy in patients presenting with late onset dyspepsia. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND AND OBJECTIVES: Uninvestigated dyspepsia is common in surgical out patient department. The prevalence of clinically significant upper gastrointestinal findings in late onset uninvestigated dyspepsia patients and their predictability based on history, is unknown. So a study was undertaken in Rajiv Gandhi Government General Hospitals, Madras Medical College, Chennai to study the endoscopic findings in dyspeptic patients and to detect the esophagogastroduodenal carcinoma in early stages. MATERIALS AND METHODS: After informed consent 200 patients aged more than 40 years presenting with uninvestigated, untreated and uncomplicated dyspepsia were enrolled and evaluated in the study. Patients aged less than 40 years, patients on Proton pump inhibitors, patients who are known cases of chronic pancreatitis and liver disease, patients on NSAID’s for more than one month duration, patients who had received Anti-Helicobacter pylori treatment and unwilling or unfit patients for endoscopy were excluded from the study. All patients underwent upper gastro-intestinal endoscopy to document the various findings. Biopsies were taken in every patient from the gastric antrum and pathological site. The biopsy specimen was subjected to histo pathological examination for confirmation .The findings were documented and analysed. RESULTS: 1. Highest prevalence of late onset dyspepsia in the age group of 41-50years. 2. Most common presenting complaint was epigastric pain and discomfort. 3. Dyspepsia was more common in males (59%) when compared to females. 4. Most common endoscopic finding was gastritis followed by GERD. 5. Malignancy was diagnosed in 6.5% patients with dyspepsia. 6. Clinically significant endoscopic findings were observed in 82.5% of patients with uninvestigated dyspepsia. 7. Most patients presented with a complex of three or more dyspeptic symptoms and the symptom profile was not predictive of the endoscopic findings. However, the high prevalence of gastritis (28%), suggests that most patients presenting with uninvestigated dyspepsia can be safely managed initially with acid suppressive drugs. CONCLUSION: Clinically significant endoscopic findings were observed in 82.5% of patients with uninvestigated dyspepsia. Most patients presented with a complex of three or more dyspeptic symptoms and the symptom profile was not predictive of the endoscopic findings. A larger number of inflammatory lesions as a result of increased acid production and low incidence of malignancy in the study group. It is suggested that the uninvestigated patients with dyspepsia may be initially managed medically with acid suppressive therapy. Endoscopy may be undertaken in patients with recurrent symptoms or in whom drug therapy fails.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Upper GI endoscopy ; dyspepsia ; H.pylori ; GERD. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 05 Jul 2018 03:43 |
| Last Modified: | 05 Jul 2018 16:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8627 |
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