Significance of Endoscopyic Findings in Patients with Dyspepsia in Diyala Province - Iraq Hospital Based Study

Background: Dyspepsia is a common gastrointestinal problem that poses a diagnostic and therapeutic challenge to the clinician because of the non-specific nature of the symptoms. Dyspepsia could be organic when a cause is found or functional (non-ulcer) when no cause is identified. Endoscopy is the gold standard in evaluating dyspeptic patients and various guidelines have been drawn to make the use of upper GI endoscopy more rational as the establishment of this procedure for every dyspeptic patient may not be practical . Objective: To evaluate the endoscopic findings in dyspeptic patients and to assess whether the major guidelines are applicable in our community. Patients and Methods: A prospective study, carried out in the upper gastro-intestinal endoscopy unit (using Pentax® 2015 endoscopy) at Baquba Teaching Hospital – DiyalaIraq, from February 2017to October 2017 in which 120 dyspeptic patients (47male and 73 female) with age range 16-75 years were included. The patients were selected according to the guidelines. A standardized data collection form was completed for each patient. Results: One hundred and twenty patients enrolled in this study, 60.83% patients were female and 39.17% of patients were male, with female to male ratio of 1.55:1. Normal endoscopic finding was found in 40% of dyspeptic patients while clinically significant endoscopic findings were found in 60% of patients. Clinically significant endoscopic findings were more prevalent in older patients. The most common pathologic finding was duodenal ulcer in 18.33% % of patients followed by gastrits in 14.17%of patients and esophagitis in 10.33% of patients. Gastric cancer was proved by histopathology in 1.67% and esophageal cancer in one patient 0.83%. Conclusion: Dyspeptic symptoms are more common in female. Normal finding was found in 40% of dyspeptic patients (functional dyspepsia) while clinically significant endoscopic findings (organic causes) were found in 60% of the dyspeptic patients and most prevalent in elderly patients, with duodenal ulcer being the most common finding followed by gastrits and esophagitis. Gastric cancer was present in 1.67% and esophageal cancer in 0.83%.