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Reassessing the value of gastroscopy for the investigation of dyspepsia
  1. Hey-Long Ching,
  2. Melissa F Hale,
  3. Reena Sidhu,
  4. Mark E McAlindon
  1. Department Of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK
  1. Correspondence to Dr Hey-Long Ching, Clinical Research Fellow, Gastroenterology, Royal Hallamshire Hospital,Sheffield Teaching Hospitals, Sheffield, S10 2JF, UK; hey-long.ching{at}sth.nhs.uk

Abstract

Objective To evaluate the diagnostic yield of investigating dyspepsia with oesophagogastroduodenoscopy (OGD) with or without mucosal biopsy.

Design Retrospective service evaluation study.

Setting Two teaching hospitals: The Royal Hallamshire Hospital and Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, UK.

Patients 500 patients, 55 years of age and over, who underwent OGD to investigate dyspepsia were included. The study period included a 3-month window. All OGDs were performed on an outpatient basis.

Interventions Data were extracted from electronic OGD records within the study period.

Main outcome measures Diagnostic yield provided by endoscopic examination and histological assessment.

Results 378 patients (75.6%) were reported to have some form of endoscopic abnormality, and 417 patients (83.4%) had biopsies taken. The most common findings at OGD were gastritis (47.2%) and oesophagitis (24.4%). Oesophagogastric malignancy was seen in 1%. Diagnoses made endoscopically or histologically that would not have been appropriately managed by empirical therapies were seen in 16.2%.

Conclusion OGD in dyspepsia influences patient management in approximately one-sixth of cases. However, the majority of patients are sufficiently managed with Helicobacter pylori testing and eradication and/or a trial of proton pump inhibitor therapy. Further non-invasive approaches are needed to identify patients who need endoscopy for biopsy or therapy.

  • gastrointesinal endoscopy
  • dyspepsia
  • gastroscopy

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Footnotes

  • Contributors MEM designed the study, assisted with interpretation of results and critically appraised the paper. H-LC led the data collection, performed the analysis and drafted the paper. MFH and RS critically appraised the paper. All authors approved the final manuscript. H-LC is guarantor.

  • Competing interests None declared.

  • Patient consent Retrospective analysis of gastroscopy reports as part of service evaluation without human subject involvement.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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