Original ArticlesDiagnostic yield of upper endoscopy in Asian patients presenting with dyspepsia☆
Section snippets
Patients and methods
Endoscopy, rather than barium contrast radiography, is the primary mode in our division for investigation of dyspepsia, which is defined as pain and discomfort centered in the upper abdomen.6 Clinical data including demographic characteristics, indications for EGD and findings for all patients undergoing upper endoscopy at our hospital in Singapore were prospectively recorded on standard forms and entered into a computer database. The patient population consisted mainly of ambulatory patients
Results
A total of 10,488 EGDs were performed over the 7-year period of the study. The indications were simple dyspepsia in 5066 patients (48.3%), hematemesis and/or melena in 1250 (11.9%), anemia/positive fecal occult blood test in 1097 (10.5%), follow-up of gastric ulcer in 707 (6.7%), dysphagia/vomiting in 445 (4.2%), weight loss in 186 (1.8%), atypical chest pain in 182 (1.7%), and other in 555 (14.8%). A total of 5066 patients (men 2356 [46.5%], women 2710 [53.5%]; median age 45 years, range 12-97
Discussion
Studies of white patients with simple dyspepsia have found an extremely low frequency of stomach cancer in patients below 45 years of age. A study from the United Kingdom that included 686 patients found no malignant disorders in patients less than 45 years old with simple dyspepsia.9 Another study from Canada found only 3 cases of gastric cancer among 3634 patients with simple dyspepsia.10 The investigators concluded that a strategy of initial noninvasive management was unlikely to negatively
Acknowledgements
We would like to thank Ms Janice Choo, Assistant Manager of Medical Records Office, National University Hospital, Professor K. Shanmugaratnam, Director of Singapore Cancer Registry, and staff of the Department of Pathology, National University of Singapore for their assistance in data retrieval, and Mr. Ivan Ho for his assistance in compilation of endoscopic data.
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Reprint requests: Khay G. Yeoh, MBBS, Division of Gastroenterology, Department of Medicine, National University Hospital, Lower Kent Ridge Rd., Singapore 119074, Lower Kent Ridge Road, Singapore 119074.