Symptom-histopathology relation in upper GI endoscopy
Emre Günay, Erkan Özkan, Hacı Mehmet Odabaşı, Hacı Hasan Abuoğlu, Cengiz Eriş, Mehmet Kamil Yıldız, Süleyman Atalay
Haydarpaşa Numune Teaching Hospital, Department of General Surgery, Istanbul, Turkey
Objective: The purpose of this article is to examine the correlation between information obtained from patients before endoscopy and histopathological findings.
Material and Methods: One thousand, five hundred and thirty-six patients underwent upper GI endoscopy between January 2011-September 2012, without distinction of age and sex were included in the study. Patients with alarm symptoms, dyspepsia, epigastric pain, gastroesophageal reflux were recorded. Tissue samples taken for histopathological examination and H. pylori screening were evaluated by Giemsa stain. The information given by the patients and histopathological findings were comparatively evaluated.
Results: Six hundred and twenty-four patients (40.6%) were male and 912 (59.4%) were female. Mean age was 45 years (18-90). H. pylori was positive in 416 patients with dyspepsia (58.8%), 172 patients with epigastric pain (54.4%), 52 patients with GER symptoms (28.3%) and 128 patients with alarm symptoms (50.8%). Four patients with dyspepsia (0.6%) and 20 patients with alarm symptoms (7.9%) were diagnosed with stomach cancer.
Conclusion: The main factor should be considered as the presence of at least one of the alarm symptoms when planning an upper GI endoscopy in a patient. In the presence of at least one of the alarm symptoms, an upper GI endoscopy should be performed regardless of age. Under the age of 50 and for patients without alarm symptoms, medical treatment can be tried before performing upper GI endoscopy. Patients with GER symptoms but not diagnosed as reflux esophagitis, should be treated long-term even when symptoms decline with initial treatment.
Keywords: Endoscopy, gastroscopy, H. pylori, gastric cancer, alarm symptoms