Gastric disease in patients presenting with dyspeptic symptoms

Abstract

INTRODUCTION: Upper gastrointestinal endoscopy and biopsy is a relatively common procedure that is now frequently used in the investigation of patients with 'dyspeptic symptoms'. OBJECTIVES: To correlate the endoscopic findings with histological features. To ascertain patterns of gastric disease occurring in patients undergoing upper gastrointestinal endoscopy and biopsy for dyspeptic symptoms. METHODS: 419 endoscopic biopsies performed on patients with dyspeptic symptoms during the period April 2000 to October 2001 were reviewed. In all patients biopsies were performed on an area of the gastric mucosa showing an endoscopic abnormality. The patients included 258 males and 161 females with ages ranging from 11-86 years (median 45.5). Most biopsies were obtained from the antral region (322/419). RESULTS: 110/419 (26%) biopsies were histologically normal despite an 'endoscopic abnormality' being reported. 15 biopsies (3.5%) were non-diagnostic due to biopsy artefacts, poor preservation and other factors. 13/419 (3%) biopsies revealed neoplastic lesions (11- malignant, 2-fundic gland cysts). Of the non neoplastic gastric disorders 33 (7.9%) were peptic ulcers, 202 (48%) chronic gastritis, 40 (9.5%) reactive gastritis, 6 (1%) portal gastropathy, 1 hyperplastic gastropathy. Helicobactorpylori was identified in 112/202 (55%) of the biopsies with chronic gastritis. CONCLUSIONS: Endoscopic and histologic correlation was satisfactory in a majority, 74% of the biopsies showing histological evidence of disease. Helicobactor pylori induced gastritis was the commonest (27%) pathology encountered in patients investigated for dyspeptic symptoms.