Open access endoscopy: A large-scale analysis of its use in dyspeptic patients

Carlo Mansi, Giuseppe Sandro Mela, Vincenzo Savarino, Maria Raffaella Mele, Francesca Valle, Guido Celle

Research output: Contribution to journalArticlepeer-review

Abstract

We examined 2,253 consecutive dyspeptic patients referred to our endoscopy service by general practitioners (“open” group) and hospital clinicians (“clinic” group) to study the prevalence of the various endoscopic findings according to patient age and the route of endoscopic referral. The results obtained are representative of that specific population. Normal endoscopic findings progressively lessened as patients' age increased, and the overall rate was as low as 26.5% in the open and 30.3% in the clinic groups. Erosive prepyloric changes and duodenitis were the most frequently noted abnormalities in patients <40 years of age (16.9% and 20.1%, respectively, in the open and 11.6% and 14.2% in the clinic groups). Chronic gastritis was prevalent in patients > 60 years of age. Duodenal ulcer decreased from 9.7% (open) and 18% (clinic) in patients <40 to 2% and 1.1% in patients > 60. No malignancy was found in patients <40, while only ∼1% of those <60 had neoplasms. All our endoscopic findings, both in the open and the clinic groups, were not significantly different. No significant differences in symptoms were observed among patients with different endoscopic findings. We conclude that (a) endoscopy is really useful only in a small group of patients > 40 years of age; (b) individual symptoms alone have a poorly discriminant diagnostic power; and (c) restriction of open access endoscopy is not justified.

Original languageEnglish
Pages (from-to)149-154
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume16
Issue number2
Publication statusPublished - 1993

Keywords

  • Dyspepsia
  • Endoscopy
  • General practice

ASJC Scopus subject areas

  • Gastroenterology

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