STUDY OF UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS AND PRESENCE OF HELICOBACTER PYLORI INFECTION AMONG ADULT PATIENTS OF UPPER ABDOMINAL PAIN AND DYSPEPSIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 23
Abstract
BACKGROUND Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. The symptoms of causes of dyspepsia often overlap and this makes aetiological diagnosis difficult. Endoscopy is the ideal procedure for identifying organic diseases of the foregut and rapid urease test with endoscopy is a gold standard method for diagnosing the h.pylori infection. Helicobacter pylori infection is associated with various upper gastrointestinal pathologies. MATERIALS AND METHODS This hospital-based case-controlled study was carried out in a tertiary hospital, Dr. Bhim Rao Ambedkar Hospital, which is attached to Pt. J.N.M. Medical College, Raipur, and which provides open access service to endoscopy. Eighty two consecutive adult outpatients and admitted patients under Department of Surgery and Medicine with upper abdominal pain and dyspepsia were screened for eligibility and underwent upper gastrointestinal endoscopy using forward-viewing endoscopes from March 2015 to September 2016. Patients with dyspepsia who are over 18 years of age should undergoendoscopy (EGD) for initial work up and divided in case having endoscopic findings and control having normal findings, then apply rapid urease test to all of these patients. RESULTS The most commonly identified endoscopic findings were gastritis (36%), Peptic Ulcer Disease (PUD) (13.3%), oesophagitis (11%), duodenitis (7.3%). Gastric cancer was identified in 4.9% of patients and all of them were aged 18 years and above (p>0.05). H. pylori infection was detected in 51% (n=42) of patients. Gastritis andoesophagitis were statistically significantly associated with H. pylori (p<0.001). No association was found between Peptic Ulcer Disease (PUD), duodenitis, gastric cancer and H. pylori infection (p>0.05). Gastritis, GERD and PUD are the leading causes of dyspepsia. H. pylori infection is present in significant proportion of dyspeptic patients. CONCLUSION In present study, we are concluded that all upper abdominal pain is not due to acid peptic disease, but most of upper abdominal pain is due to acid peptic disease with H.pylori positivity. This would prevent irrational use of antacids and antisecretory drugs. So patients having longer symptoms should have always screen for RUT testing. Screening of H.pylori which highly prevent the patients more succeptible for carcinoma of stomach and awareness of the disease makes the present to hospital at earlier stage and prevent devastating complications.
Authors and Affiliations
Manju Singh, Amit Agrawal, Nishant Bhagwan Karwade
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