Upper GI endoscopy for dyspepsia may detect organic lesions in sizable number of patients

SHIMLA: With upper GI endoscopy, the examination of alarm characteristics in dyspepsia patients younger than 60 years of age reveals organic lesions (65.3%), including malignancy (15.6%) in a considerable proportion of patients, according to recent research published in Indian Journal of Gastroenterology.

Globally, primary care patients frequently have digestive diseases, particularly dyspepsia. According to more recent American College of Gastroenterology (ACG) and Canadian Association of Gastroenterology (CAG) guidelines, people with dyspepsia under the age of 60 should not undergo endoscopy to rule out upper gastrointestinal (GI) neoplasia.

"This recommendation's applicability to our population has not been tested," Vishal Bodh, Department of Gastroenterology and team wrote.

In order to rule out upper GI neoplasia in dyspepsia patients younger than 60 years of age, this study evaluated the relevance of upper GI endoscopy.

To identify organic lesions and malignancies, 294 dyspepsia patients between the ages of 18 and 60 who had at least one or more alarm symptoms (unintentional weight loss, loss of appetite, GI bleeding, anemia, recurrent or persistent vomiting, dysphagia with predominant epigastric pain, and family history of upper GI cancer) were evaluated in this prospective observational study.

Conclusive points of the research:

• Functional dyspepsia (FD) was present in 34.7% (n=102) of the patients, while abnormal endoscopic results were present in 65.3% (n=192) of the patients (organic dyspepsia [OD]).
• 46 individuals (15.6% of the total study population) had upper GI tract malignancy (malignant OD) out of the 192 patients with OD, while 146 patients (49.6% of the total study population) had benign abnormalities (benign OD).

An organic lesion (65.3%), including malignancy (15.6%), is found in a considerable portion of dyspepsia patients who have their alarm features investigated with upper GI endoscopy, concluded the authors.

REFERENCE

Kumari, P., Machhan, P., Sharma, B. et al. Dyspepsia with alarm symptoms in patients aged less than 60 years: Is upper gastrointestinal endoscopy justified in Indian scenario?. Indian J Gastroenterol (2022). https://doi.org/10.1007/s12664-022-01275-y