Dyspepsia:Functional Vs Organic and Prevalence of Upper Gastrointestinal Lesion in Dyspepsia
Subscribe/Renew Journal
Aim and Objectives: To know distribution of functional and organic dyspepsia and prevalence of upper gastrointestinal lesions in patients with dyspepsia.and also to determine diagnostic yield of upper gastrointestinal endoscopy in cases of dyspepsia.
Methods and results: This was a prospective study of 87 cases to know the various upper gastro-intestinal endoscopic findings in patients presenting with dyspepsia in outpatient and inpatient departments at Aditya Birla Memorial Hospital, a tertiary care hospital. All patients of age 18-75 years of either sex complaining of dyspepsia and agreed to undergo UGI endoscopy were included dyspepsia defined as pain in abdomen or heart burn, early satiation of >1 month with nausea, vomiting ,belching, flatulence, anorexia, dysphagia, water brushes, postprandial discomfort or fullness/distension.
Results and observations: Most common presenting complaint was epigastric pain and nausea or vomiting. Dyspepsia was more common in males (63.2%) than to females (36.8%). Highest prevalence of dyspepsia in the age group of 21-30 years (32.2%) followed by 28.7% in age group >50 then 26.4% in age group 31-40 years. Endoscopic findings shows 81.6% were organic cause and 18.4% have normal or functional cause. Most common endoscopic finding was gastritis (47.13%) followed by Esophagitis (16.09%) then Duodenitis (05.75%). H.pylori infection was present in 19.5 % of study population and had significant association for organic dyspepsia. (Fisher exact test=0.034) Malignancy was diagnosed in 2.29% patients with organic dyspepsia. Smoking and NSAIDs have high risk than other associated risk factors like caffeinated drinks/carbonated drinks/Alcohol/Stress. Majority of the patients in this study had dyspeptic symptoms for a period of <1 year (67.8% had <6 months and 18.4% had 7-12 months) and followed in by >1 year (13.8%) duration of symptoms. Duration of symptoms >12 months had significant association for organic dyspepsia (P Value <0.001)
Conclusion: Upper GI endoscopies had good diagnostic yield in various upper GI lesions. Clinically significant endoscopic findings were observed in 81.6% of patients. H.pylori infection (Prevalence 19.5%) was significantly associated with organic dyspepsia. Smoking, excess use of NSADs has high risk for functional and organic dyspepsia, than caffeinated drinks/carbonated drinks/Alcohol.
Keywords
- Tack J, Bisschops R, Sarnelli G: Pathophysiology and treatment of functional dyspepsia. Gastroenterology 2004; 127:1239-1255.
- Chang L. Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther 2004; 20Suppl7:31-39.
- Haycox A, Einarson T, Eggleston A. The health economic impact of upper gastrointestinal symptoms in the general population: results from the Domestic/ International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol 1999; 231 (Suppl):38-47.
- Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GN. Functional gastroduodenal disorders. Gut 1999;45(2):II37-42.
- Tack J, Talley NJ, Camilleri M, et al: Functional gastroduodenal disorders. Gastroenterology 2006; 130:1466-1479.
- Talley NJ , Silverman MD , Agreus L, Holtmann G. Evaluation of dyspepsia. Gasenterol. 1998;114:582-95.
- Agréus L. Natural history of dyspepsia. Gut 2002;50(4):iv2-9.
- Locke GR 3rd. Prevalence, incidence and natural history of dyspepsia and functional dyspepsia. Baillieres Clin Gastroenterol 1998;12:435-42.
- Braunwald E. Harrison’s principles of internal medicine.15 ed. New York: McGraw-Hill; 2001.
- NICE(CG17) Dyspepsia: Managing dyspepsia in adults in primary care. August 2004
- Talley NJ, Vakil NB, Moayyedi P. American Gastroenterological Association technical review on the evaluation of dyspepsia. Gastroenterology 2005; 129:1756-80.
- Talley NJ, Phung N, Kalantar JS. ABC of the upper gastrointestinal tract: Indigestion: When is it functional? Br Med J 2001; 323 (7324):1294–7.
- Koch KL, Stern RM. Functional disorders of the stomach. Semin Gastrointest Dis 1996; 7(4):185-95.
- Williams B, Luckas M, Ellingham JHM, Dain A, Wicks ABC. Do young patients with dyspepsia need investigation? Lancet 1988; 2:1349-51.
- Wiklund I, Glise H, Jerndal P, Carlsson J, Talley NJ. Does endoscopy have a positive impact on quality of life in dyspepsia? Gastrointest Endosc 1998; 47(6):449-54.
- Adang RP, Vismans JF, Talmon JL, Hasman A, Ambergen AW, Stockbrügger RW. Appropriateness of indications for diagnostic upper gastrointestinal endoscopy: association with relevant endoscopic disease. Gastrointest Endosc 1995; 42(5):390-7.
Abstract Views: 279
PDF Views: 0