Evaluation of persistent upper abdominal pain by upper gastrointestinal endoscopy

Abstract

Background: The upper gastrointestinal tract is affected by a spectrum of conditions which span from infectious, idiopathic, inflammatory diseases, polyps, motility disorders and malignancy. Upper gastrointestinal scopy is believed to be the most effective screening modality as it not only allows direct visualization of oesophagus, gastric and duodenal mucosa but to perform biopsies in suspected malignancies. Aim: To evaluate persistent upper abdominal pain by upper gastrointestinal scopy.Methods: A total of 100 patients presented with complains of persistent upper abdominal pain were subjected to upper gastrointestinal scopy. Biopsies in indicated cases were taken from abnormal areas and sent for histopathology.Results: Most common finding in patients according to upper gastrointestinal scopy was gastritis (27%), followed by duodentitis (9%), and gastroduodenitis (7%). Rapid urease test in cases of gastritis and duodenitis to determine H. pylori infection were positive in 53.8% cases.Conclusions: Because of its precision and relatively safe technique upper GI endoscopy can be considered in patients above age of 50 years presenting to surgical OPD with complaints of persistent pain in upper abdomen. Investigating helicobacter pylori should be considered in all patients found to have gastric or duodenal lesions on upper GI endoscopy as its association with these lesions ranges from 50 to 80%.

Prevalence of Gastritis in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…5 , 10 Similar finding was also seen in studies done in India, Uganda, Ghana and Nigeria. 9 , 11 - 13 Gastrointestinal bleeding was the presentation in few, though not the majority of the patients. Alarming symptoms like vomiting, weight loss and anemia were present in a negligible number of cases.…”

“…Also, studies done outside Nepal showed gastritis as the commonest finding in patients undergoing endoscopy. 9 , 11 , 12 , 14 , 15 …”

“… 12 In another study done by Patel et al among patients with persistent upper abdominal pain, 22% of cases had normal upper gastrointestinal endoscopy findings. 11 This is a significant number that may account for the overutilization of endoscopy in day-to-day practice. This aspect has also been highlighted in the study done by Bohara et al in 2017 A.D in a medical college in Kathmandu.…”