Dyspepsia: Functional vs Organic and Prevalence of upper gastrointestinal lesion in dyspepsia

Dr Sandeep Bhavsar, Smita, Mrunmay Panda

Dr Sandeep Bhavsar, Smita, Mrunmay Panda

Keywords: Dyspepsia, Gastritis, Duodenitis, H pylori, Epigastric pain

Abstract

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 18-75years 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.

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