Endoscopic Evaluation of Dyspeptic Patients with Alarm Symptoms

Abstract

Background: Dyspepsia is defined as chronic or recurrent pain or discomfort centered in the upper abdomen characterized by nausea, vomiting, bloating, and early satiety. It’s a common problem in the community and clinical practice. All guidelines recommend that patients older than 45 years and those with alarm symptoms should have a prompt endoscopy. There is a lack of data on endoscopy in patients with alarm features in Bangladesh.

Methods: A prospective cross-sectional study of the endoscopic findings in adults with dyspepsia and alarm features in Khulna, Bangladesh. After collection, data editing and clearing were done manually and prepared for data entry and analysis by using SPSS version 17.

Results: Fifty dyspeptic patients underwent endoscopies performed during 6 months, with a mean age of 42.12 (±14.69) years, 56% were male, and 44% were female. Most of the patients' education was primary level (74%). The majority of the patients were service holders (50%). Abdominal pain (86%) was the highest alarming symptom, while weight loss (6%) was the lowest. In endoscopic examination, normal findings that are functional dyspepsia were highest (40%), found less in suspected esophageal malignancy (02%). Nutrition status of these patients was average (58%), malnourished were (42%). In the distinct age group (≥ 50 years), vomiting, haematemesis and melaena were the highest alarming symptoms. Vomiting (63.6%) was the highest alarming symptom in the female group, while melaena (57.14%) was the highest alarming symptom in the male group.

Conclusion: Although the presence of alarm symptoms predicts a bad prognosis, the positive predictive values were low and the negative predictive values high, reflecting low incidences of the diseases in the population at risk. The majority of patients who developed cancer or ulcer did not present with alarm symptom(s) at the initial consultation.

Mediscope 2026;13(1): 58-64