Clinical, Endoscopic and Histopathological Patterns among Patients with Dyspepsia

Aim: Dyspepsia is a term differently understood, and associated with various upper gastro-intestinal endoscopic and histopathologic patterns. Most patients have regarded upper abdominal pain as ‘peptic ulcer disease’ with resultant late presentation of upper gastro-intestinal malignancies in some cases. This study examined the clinical presentation, endoscopic and histopathological patterns among patients with dyspeptic symptoms in Nnewi, South-East Nigeria.

Methods: This hospital based descriptive cross-sectional study examined 352 patients presenting with dyspepsia. Abdominal ultrasound was used to exclude patients with dyspepsia of biliary or pancreatic origin. An interviewer administered questionnaire (using the short form Leeds dyspepsia questionnaire) was used to describe dyspepsia patterns, and gastroscopy done on the included patients following an overnight fast. Samples obtained from endoscopy were assessed histologically for morphology and presence of H. pylori organism.

Results: Most participants belonged to 55 to 74 years age group with a mean age of 52.27±2.59 years. Epigastric discomfort (96.9%), heart burn (63.1%) and belching (55.4%) were the commonest symptoms. The commonest endoscopy and histopathologic findings was chronic gastritis (63.06% and 51.99% respectively), although there was poor agreement between the two modalities.

Conclusion: Histology remains the goal standard for diagnosis. However, we recommend endoscopy for dyspeptic patients especially in the elderly to enhance early detection of cancers, which were significant in this study.