Background: Epidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries. Objective: This paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis. Methods: A cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20. Results: A total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding. Conclusion: There is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology. Keywords: Gastric ulcer; duodenal ulcer; endoscopy.

Background and aim Clinical and endoscopic parameters are predictive of patient outcome following acute upper gastrointestinal bleeding. The study aimed to investigate factors related to re-bleed and mortality following initial endoscopy among Nigerian patients with recent upper gastrointestinal bleeding (UGIB). Methods This is a cohort study of patients undergoing endoscopy for recent-onset UGIB at a referral endoscopy facility in Port Harcourt, Rivers State, Nigeria, from April 2014 to November 2020. Patients’ demographic and clinical data, American Society of Anesthesiologists (ASA) physical status, amount of blood transfusion, endoscopy results, and Rockall scores were retrieved from patients’ charts. The re-bleed and mortality rates were noted on follow-up by telephone. Statistical analysis was performed using SPSS version 20 (IMB Inc., Armonk, USA). Results A total of 560 patients had flexible video oesophagogastroduodenoscopy during the study period, and 46 (8.2%) of these were included in the study. Their age ranged from 28 years to 84 years (mean 58.6 ± 15.8 years) with 32 (69.6%) males and 14 (30.4%) females. Peptic ulcer disease (PUD) and gastritis/gastric erosions were the leading endoscopic diagnoses in 24 (52.2%) and 12 (26.1%) patients, respectively. Multiple comorbidities (p=0.021) and higher ASA score (mean 3.0; 95% confidence interval CI: 2.47-3.53; p=0.021) are associated with re-bleed, which was recorded in seven (15.2%) patients. Four (8.7%) cases of mortality were recorded in patients with a mean full Rockall score of 4.25 (95% CI: 1.52-6.97; p=0.021). Conclusion Re-bleed is more common in patients with multiple comorbidities, ASA score of three or more, and bleeding gastro-oesophageal varices at initial endoscopy. Mortality was significantly higher in patients with a full Rockall score of more than three.

Introduction an adequate bowel preparation is essential for good mucosal inspection during colonoscopy. This study aims to compare the efficacy of two validated oral lavage solutions for colonoscopy preparation in African patients. Methods a prospective observational study of patients undergoing colonoscopy in a referral endoscopy facility in Port Harcourt, Nigeria, using sodium picosulfate magnesium citrate (SPMC) and 4L split-dose polyethylene glycol (PEG). Variables collated were sociodemographic, primary indication, comorbidities, Aronchick bowel preparation scale, polyp/adenoma detection, caecal intubation and outcome. Statistical analysis was performed using IBM SPSS version 20. Results one hundred and twenty-four patients received PEG prior to colonoscopy and SPMC in 175 patients. The age range was from 22 to 92 years; mean age of 53.8 ± 14.2 years for PEG group and 55.3 ± 13.2 years for SPMC group (p=0.361). There were 215 males and 84 females. An excellent/good bowel preparation scale was recorded in 77 (62%) PEG group and 130 (74.3%) for SPMC group (p=0.592). PEG was predominantly used in the early years of endoscopists practice with the odds ratio (OR) of no polyp detection in the PEG vs SPMC groups as 1.64 (confidence interval CI 1.06-2.55) versus 0.76 (CI 0.62-0.92), respectively (p=0.016). For no adenoma detection, OR was 4.18 (CI 1.12-15.60) versus OR 0.63 (CI 0.52-0.75), respectively (p=0.012). Conclusion there is similar efficacy profile using either split volume PEG or SPMC prior to colonoscopy in these African patients. Polyp and adenoma detection rates are highly dependent on the expertise of the endoscopist.