An Audit of more than a Thousand uppergastrointestinal Endoscopy in a Tertiary Care Teaching Hospital in South India

Abstract

Background: Esophagogastroduodeno (EGD) scopy is a benchmark in the modern era of medicine. It is a sensitive tool used to evaluate the upper gastrointestinal (GI) symptoms. Application of EGDscopy is not merely restricted to diagnosis but as well used for therapeutic purpose. Aim of the Study: To find out the common indications for EGDscopy and its findings in a large tertiary care hospital attached to Bangalore medical college and research institute (BMCRI), Bengaluru. Materials and Methods: A retrospective study was conducted on 1030 patients either admitted or seen on outpatient basis at the Bowring and Lady Curzon hospital attached to BMCRI, Bengaluru with the upper GI symptoms like dyspepsia, dysphagia, epigastric pain abdomen, hematemesis etc from September 2016 to August 2018 and the data was analyzed using appropriate statistical methods. Results: Out of 1030 patients who underwent EGDscopy 62% were male and 61% were 31-59year old. The major indications for EGDscopy were epigastric abdominal pain (18%), dyspepsia (18%), chronic liver disease (15%), dysphagia (11%) and hematemesis (8%). The common pathological findings in the above mentioned indications were gastritis and esophagitis in patient with both epigastric abdominal pain and dyspepsia, portal hypertensive gastropathy and esophageal varices in chronic liver disease, esophageal growth in dysphagia and esophageal varices (EV) in cases of hematemesis. Conclusions: The following insights/observations were made during the course of our study-dysphagia is not just oropharyngeal or esophageal in origin but H. pylori gastritis can cause similar complaints, eradication of which relieves the symptoms in our observation. Chronic abdominal pain associated with postprandial urgency which is deemed as Inflammatory Bowel Disease-Diarrhea (IBS-D) may actually be H. pylori gastritis with exaggerated gastro-colic reflex which gets relieved with anti- H. pylori treatment; further studies are needed to prove this claim. Mosaic like pattern with focal areas of hyperemia in the gastric body mucosa is not just typical of portal hypertensive gastropathy but also can be seen with H. pylori gastritis. Corrosive acid ingestion as a mode of suicidal attempt is common in this part of India which can lead to morbidity and even mortality in severe cases, legislative measures need to be put in place to check the sale and use of corrosive acid. Diffuse white spots in duodenum were mostly due to chronic nonspecific duodenitis rather than intestinal lymphangiectasia in our study.