Study on the role of endoscopy in dyspepsia symptom complex

Visakan, M (2015) Study on the role of endoscopy in dyspepsia symptom complex. Masters thesis, Kilpauk Medical College, Chennai.


Download (3MB) | Preview


INTRODUCTION Dyspepsia is not a diagnosis but it refers to a group of symptoms related to the pathology of upper gastrointestinal tract1. According to American gastroenterological association dyspepsia refers to chronic and recurrent pain or discomfort centred in the upper abdomen. Rome III criteria for dyspepsia must include one or more of the following: postprandial fullness, early satiation, epigastric pain, epigastric burning. A clear diagnosis based on these symptoms will be difficult. Many diseases cause dyspepsia namely gastric and duodenal ulcers, oesophagitis, gastric and pancreatic cancer, gall stones etc. But in majority of patients with dyspepsia no clear pathologic cause can be determined and it is known as functional dyspepsia. Upper gastro intestinal endoscopy is the most sensitive test for patients presenting with dyspepsia. But when taken into account, in the large population of dyspeptic patients endoscopy cannot be done practically for all of them. It is even more difficult in developing countries like India where diagnostic facilities are limited. There is no standard age cut off for patients above which endoscopy is indicated. So this topic was undertaken in Kilpauk medical college in Chennai to study the role of endoscopy in management of patients with dyspepsia symptom complex. AIM OF THE STUDY: 1. To study the various endoscopic findings in dyspeptic patients and to study the usefulness of endoscopy in patients presenting with dyspepsia with or without alarm symptoms. 2. Incidence of H pylori in patients with dyspepsia. 3. Incidence of oesophageal and gastric cancer in patients presenting with dyspepsia. METHODOLOGY: This is a prospective clinical study done at Kilpauk Medical College, Chennai, to find out the role of endoscopy in dyspeptic patients. The study duration was ten months from October 2013 to July 2014. Patients were selected using convenient sampling. Patients were included after getting their informed written consent for the procedure. Thorough clinical history was obtained through the proforma including the presence of alarm symptoms. Basic investigations were done. Ultra sonogram of the abdomen done to look for gall stone or any mass lesion. Then the patients were subjected to endoscopy and findings were noted. All the instruments were washed with distilled water to prevent error due to pH change. Inclusion Criteria: a. patient age should be above 12 years b. patient for whom endoscopy was not previously done. Exclusion criteria: a. patients below 12 years, b. already known case of liver disease, pancreatitis, gall stone, c. patient with unstable cardiac status, d. pregnant women, e. patient for whom endoscopy has already been done, f. intake of NSAID, antibiotics or proton pump inhibitors within 15 days, g. gastro intestinal bleeding, h. severe systemic illness, i. patient not willing for the procedure. RESULTS: Totally 150 patients were taken for the study by convenience sampling method. Among which 92 were males and 58 were females. The patients were in age group ranging from 13 years to 86 years and the mean age was 43 years. CONCLUSION: Based on the present study on ―The role of endoscopy in dyspepsia symptom complex‖ done in Kilpauk Medical College, Chennai. we conclude that, - Prevalence of dyspepsia was more in 31-40 years age group and more common in males than females. - Epigastric pain or discomfort is the most common presenting symptom in dyspeptic patients. - Gastritis was the most common endoscopic finding. - Among the study population H pylori prevalence was 39%. - Incidence of malignancy among the study population was 4%. - Among the 6 malignant positive cases 5 were above 50 years of age. - Endoscopy should be recommended for patients presenting with dyspepsia with alarm symptoms as the correlation between alarm symptoms of dyspepsia and gastric lesions were significant. - In patients without alarm symptoms below 50 years of age there was no significant endoscopic findings. So these patients should be treated initially rather than subject them to endoscopy. - H pylori prevalence was more in age group above 50 years than younger age group thus H pylori infection increases with age. - Smoking is an important risk factor for H pylori infection. - Presence of lymphoid follicles in histopathology significantly correlates with H pylori infection.

Item Type: Thesis (Masters)
Uncontrolled Keywords: endoscopy ; dyspepsia symptom complex.
Subjects: MEDICAL > General Surgery
Depositing User: Kambaraman B
Date Deposited: 02 Oct 2018 13:39
Last Modified: 03 Oct 2018 03:23

Actions (login required)

View Item View Item