Role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population

Abstract

Background and Objectives: Before the advent of endoscopy direct access to the lesion for the confirmation of the diagnosis was difficult, this posed difficulty in contemplating adequate and appropriate surgery. Endoscopy as a diagnostic and therapeutic tool has grown in recent years. Upper gastrointestinal (GI) endoscopy is one of the most fascinating branch which serves not only as a means of resolving or amplifying the diagnosis made clinically or by X-ray, but also a primary diagnostic procedure for conditions not otherwise diagnosable on unoperated case. Fiber optic upper GI endoscopy has already become firmly established as a reliable, quick and inexpensive tool. This study was done to detect the upper gastrointestinal lesions in rural population of Kolar District, the distribution pattern of various upper GI lesions in patients presenting with upper GI symptoms and to follow the endoscopic diagnosis for medical and surgical management. Materials and Methods: The study group includes patients reporting to outpatient department and also the inpatients in wards of General Surgery and other departments, who have upper GI symptoms, were advised endoscopy at R. L. JALAPPA Hospital and Research Centre, Kolar, from a period of December 2011 to August 2013. Results: Of the 600 cases, 370 were males, and 230 were females. Disease incidence was highest in 51–70 years age group, that is, 21.6%. Pain abdomen was the most common symptom. Epigastric tenderness was the most common sign among the patients clinically. Reflux esophagitis and diffuse gastritis formed most common cases (307 cases). The incidence of duodenitis - 7.83%, peptic ulcer -3.3%, esophageal varices - 1.5%, the incidence of carcinoma esophagus and carcinoma stomach was approximately same that is, 4.5% and 4.6% respectively. The incidence of esophageal candidiasis was 4.16%. The majority of the patients had a normal study that is, 14.5%. Conclusion: Upper GI lesions were more common in males. The incidence of diseases was highest among the elderly age group. Most of the benign mucosal lesions were mainly due to spicy food and habit of tobacco consumption. The incidence of malignancy was mostly among older age group above 50 years. The incidence of the normal study was high owing to increased medical care, easy availability of the procedure and increased medical awareness among patients. In all these cases, upper GI endoscopy not only helped in diagnosing the disease but also helped to get information about pathology, extent of disease and complications that have occurred. This study highlights the importance of diagnostic and therapeutic uses, recording of the various gastroenterological diseases we come across in rural population.

Disease pattern by upper gastrointestinal endoscopy in rural areas of Tiruchirappalli district carried out at CMCH and RC Irungalur, retrospective study and comparative analysis with other contemporary studies in India

“…However, Increased incidence of 4.6% was reported by Javali et al and Khan Y et al in other regions. 4,14 The incidence of oesophageo gastric junction carcinoma in the present study was 0.3%, consistent with the study of Antony B et al was 0.5% and by Khaliq M et al was 0.2%. 3,7 The miscellaneous pathologies as in Table 1 was 5.9% which was slightly greater than the study done by Khan Y et al at 3.5% and lower than 7% reported by Khaliq M et al 7,14 …”

“…The proportion of normal study in the Institution was 6% which is less compared with other studies (Table 4). 4.45% -2.89 -Shresta R et al reported the incidence of gastritis at 41.6% which was almost to equivalent to the present study of 44.1%. 9 On comparing the data with other rural population, the incidence of gastritis was found to be high in all the studies compared to other diseases irrespective of rural or urban study (Table 4).…”

“…12 The incidence of duodenal ulcer in the present study was 5.6% which was high when compared to other rural population of South India, but was less compared to the study done by Sumathy et al which was 10.9% and 18.6% by Kumar S et al 10,16 The incidence of oesophageal cancer in the present study was 2.1 % which was higher compared to study by Babu Antony et al 0.7% and 1.6% Khaiiq M et al 3,7 The study was compared with other rural population of South India where such incidence was high with Javali et al, 4.5% and Ingty et al, 4.45%. 4,15 The incidences of gastric malignancy in the present study were 1%. However, Increased incidence of 4.6% was reported by Javali et al and Khan Y et al in other regions.…”

Evaluation of persistent upper abdominal pain by upper gastrointestinal endoscopy

“…In study done by Javali et al the incidence of gastritis was 26.13%. 2 Similar study done by Chandial et al, the incidence of gastritis was 21.7%. 4 In a similar study done by Kunar et al the incidence of gastritis was 30%.…”

“…A similar study conducted by Javali et al role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population. 2 Male predominance was seen 61.6%. Majority of cases were in 61 and above.…”