Endoscopic findings and clinical predictors of organic disease among patients with dyspepsia in Jos, Nigeria

Abstract

Introduction: Dyspepsia is a common reason for seeking Medicare in the primary health care setting and beyond. However, a major challenge in evaluating patients with dyspepsia is distinguishing between peptic ulcer disease, functional dyspepsia and gastric malignancy. In most cases, the underlying cause of dyspepsia will not be obvious based on clinical history and physical examination alone. This study was carried out to characterize dyspepsia symptoms and determine predictors of organic disease among dyspepsia patients at the Jos University Teaching Hospital, Jos, Nigeria.
Materials and Methods: A prospective cross-sectional study of consecutive adult patients with dyspepsia referred for gastroscopy at the Jos University Teaching Hospital (JUTH, North-Central Nigeria was carried out. After an overnight fast, a detailed clinical history and physical examination was carried on each subject before undergoing upper gastrointestinal endoscopy using Olympus fibreoptic gastroscope. Two pairs each of gastric antral and corpus biopsies were taken from each subject and examined for the presence of Helicobacter pylori using rapid urease test. The data obtained were analyzed using the SPSS Version 15.0 Statistical soft-ware package. P values of < 0.05 were considered statistically significant.
Results: One hundred and forty four patients made up of 58(40.3%) males and 86(59.7%) females were studied. One hundred (69.4%) patients had normal findings at endoscopy (functional dyspepsia), while 44 (30.6%) had various organic findings at endoscopy (organic dyspepsia). There was no statistically significant difference between the mean ages and sex distribution for the two groups (P value >0.05). Anorexia, weight loss and epigastric tenderness were significantly more in those with organic dyspepsia compared to non-ulcer dyspepsia (P value <0.05). The prevalence of Helicobacter pylori infection was high in both non-ulcer and organic dyspepsia groups and there was no statistically significant difference between the two groups (P value >0.05).
Conclusion: Dyspepsia is a common condition among patients although symptoms, physical examination and the presence or otherwise of H. pylori infection have poor predictive values for organic disease at endoscopy, the presence of anorexia, weight loss and epigastric tenderness may be pointers to the presence of an underlying organic pathology at endoscopy.

Keywords: Endoscopic findings, Dyspepsia, predictors, Organic Disease, Jos, Nigeria