Korean J Gastroenterol.  2012 Apr;59(4):275-281. 10.4166/kjg.2012.59.4.275.

Association between Dyspepsia and Upper Endoscopic Findings

• Jung HK
• Kim SE
• Shim KN
• Jung SA

• KMID: 1364830
• DOI: http://doi.org/10.4166/kjg.2012.59.4.275

Abstract

BACKGROUND/AIMS
We aimed to estimate the proportion of significant endoscopic findings and their association with dyspeptic symptoms and to evaluate the predictors for significant endoscopic findings.
METHODS
Total of 3,872 subjects (58.3% men, mean age 43.6+/-9.3 years) who had undergone endoscopy were enrolled at the health promotion center. Each subject completed validated questionnaires, including data on gastrointestinal symptoms, socio-demographic history and medical history. Significant endoscopic findings were included peptic ulcer disease, reflux esophagitis, gastric cancer, Barrett's esophagus and gastro-duodenal erosions. Multiple logistic regression models were used to assess the predictors for significant endoscopic findings.
RESULTS
The proportion of significant endoscopic findings was 39.1%. There was no significant difference of endoscopic findings between the dyspepsia and asymptomatic group (41.0% vs. 37.4%, p>0.05). There was no difference of the incidence of reflux esophagitis or peptic ulcer between subjects with and without dyspepsia. Peptic ulcer was more frequently present in subjects with reflux symptoms than asymptomatic subjects (12.3% vs. 9.0%, p=0.03). Male gender (odds ratio [OR], 3.91; 95% confidence interval [CI], 3.18-4.81) increased the risk for having endoscopic abnormality and having symptoms of functional dyspepsia according to Rome III criteria (OR, 0.75; 95% CI, 0.57-0.97) significantly decreased this risk.
CONCLUSIONS
About 40% of subjects with dyspepsia had abnormal endoscopic findings, and the dyspepsia symptoms may not predict the significant endoscopic findings. Diagnostic criteria of functional dyspepsia by Rome III may be useful to predict not having significant upper endoscopic findings.

Keyword

Dyspepsia; Endoscopy; Upper gastrointestinal tract; Peptic ulcer; Gastroesophageal reflux

MeSH Terms

Adult
Aged
Aged, 80 and over
Dyspepsia/*diagnosis
Female
Gastroesophageal Reflux/diagnosis/epidemiology
*Gastroscopy
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Peptic Ulcer/diagnosis/epidemiology
Postprandial Period
Predictive Value of Tests
Questionnaires
Severity of Illness Index
Sex Factors
Upper Gastrointestinal Tract/pathology
Young Adult

Figure

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  Fig. 1 Proportion of upper gastrointestinal (GI) symptoms according to reflux esophagitis, gastric ulcer and duodenal ulcer. (A) Upper GI symptoms in reflux esophagitis. (B) Upper GI symptoms in peptic ulcer disease. GERS, gastroesophageal reflux symptoms, such as heartburn or acid regurgitation; EPS, epigastric pain syndrome; PDS, postprandial distress syndrome; LA-A, Los Angeles classification A; LA-B&C, Los Angeles classification B&C; GU, gastric ulcer, including active and healing stage ulcer; DU, duodenal ulcer, including active and healing stage ulcer. aComparison of the proportion of GERD symptoms between GU vs. gastritis (8.9% vs. 14.9%, p=0.042).

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