The meaning of warning symptoms in the patients with dyspepsia

Han, Chang Hee; Lee, Joon Seong; Ahn, Jae Ouk; Jun, Sang Hoon; Jung, In Seop; Koh, Bong Min; Hong, Su Jin; Ryu, Chang Bum; Kim, Jin Oh; Cho, Joo Young; Lee, Moon Sung; Shim, Chan Sup; Kim, Boo Sung

Abstract

BACKGROUND: We tried to assess whether the presence of warning symptoms and age could be useful indicators for performing endoscopy in patients who suffer from various organic gastrointestinal diseases.
METHODS
Between May 2005 to August 2005, 827 subjects who visited the health care center were studied via questionnaires and performing upper endoscopy. The questionnaires evaluated the presence and pattern of dyspepsia and the warning symptoms.
RESULTS
A total of 808 patients were enrolled. The mean age of patients was 44.6+/-8.9 years (mean+/-SD) with a male to female ratio of 1.2:1. 153 patients (18.9%) were diagnosed with confirmed organic diseases and 52 patients (6.4%) were diagnosed with definite organic diseases. The total number of organic diseases and definite organic diseases (gastroduodenal ulcer, reflux esophagitis and advanced gastric cancer) was statistically higher in the male population (p=0.001 in both). The relative risk of dyspepsia, the presence of warning symptoms and each warning symptom for the organic disease and definite organic diseases were not consistently higher for the males or females. The males over fifty years and the males over sixty years age had a relative risk of 2.046 (95% CI: 1.27~3.30) and 3.105 (95% CI: 1.39~6.95) for organic disease and 1.913 (95% CI: 0.97~3.77) and 5.333 (95% CI: 2.15~13.22) for definite organic disease, respectively. For the male patients over fifty or sixty years old with dyspepsia or warning symptoms, there were tendencies to increase the relative risk of definite organic disease rather than organic disease.
CONCLUSIONS
The relative risk of organic diseases in the presence of warning symptoms in males of over fifty years or sixty years age was not sufficiently significant for differentiating organic diseases. Thus, warning symptoms, old age and presence of dyspepsia alone can not be used as a predictor to guide endoscopic examination.