Indications and Findings of Upper Gastrointestinal Endoscopy at a Tertiary Hospital in Ethiopia: A Cross-Sectional Study

Abstract

Background

Gastrointestinal disease is a significant global health problem. Symptoms related to digestive system diseases negatively affect quality of life and impose a significant economic impact. Upper gastrointestinal symptoms are common in the Ethiopian population, and the associated pathologies are diverse. Real-time endoscopic visualization of the upper gastrointestinal tract is crucial for diagnosis. However, local data on the indications for endoscopic evaluation and the common underlying pathologies are limited. This study aimed to assess the common indications and upper gastrointestinal endoscopic findings of patients presenting to Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Methods

A cross-sectional study was conducted by reviewing the complete records of patients who underwent upper gastrointestinal endoscopic evaluation between January 2012 and December 2019. A structured checklist was used to screen records for completeness. Data were analyzed using Statistical Package for the Social Sciences software version 25. Chi-square test was used to compare variables, with statistical significance set at P < 0.05.

Results

A total of 5753 patients underwent complete upper gastrointestinal tract endoscopic evaluation during the study period. The median age of the patients was 37 years. Males accounted for 63.4% of the patients. Dyspepsia (27.8%) was the most common indication for upper gastrointestinal endoscopic evaluation, followed by upper gastrointestinal bleeding (17.1%), and screening for varices (16.8%). Esophageal varices (35.8%), gastritis (18.1%), and duodenal ulcers (10.6%) were the most common pathologies found on esophagus, stomach, and duodenum, respectively. Common upper gastrointestinal pathologies are predominant among males and patients in their third decade of life.

Conclusion

Dyspepsia was the most common indication for endoscopic evaluation of the upper gastrointestinal tract. Esophageal varices were the most common pathological finding, followed by gastroesophageal reflux disease, gastritis, portal hypertensive gastropathy, duodenal ulcer, and hiatal hernia. Esophagogastroduodenoscopy remains a vital tool for the diagnosis of pathologies of the upper gastrointestinal tract.

Keywords:

• dyspepsia
• gastritis
• GERD
• esophageal varices
• Ethiopia

Abbreviations

CLD, Chronic Liver Disease; EGD, Esophagogastroduodenoscopy; GERD, Gastro-Esophageal Reflux Disease; GI, Gastrointestinal; GOO, Gastric Outlet Obstruction; GOV, Gastro-Oesophageal Varices; IGV, Isolated Gastric Varices; LA, Los-Angeles; PHG, Portal Hypertensive Gastropathy; SPHMMC, St. Paul’s Hospital Millennium Medical College; SPSS, Statistical Package for the Social Sciences; UGIE, Upper Gastrointestinal Endoscopy.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

The study was conducted following Helsinki Declaration. Ethical clearance was obtained from the Institutional Review Board of St. Paul’s Hospital Millennium Medical College (approval number: P.M. 23/738). We reviewed the patient records from the endoscopy unit of the institution. As part of the preprocedural requirement of the unit, each patient who was referred for upper GI endoscopy signed a consent form for the procedure, which also states that the study information/findings can be used by the institution for academic and research purposes. For underaged patients, informed consent was obtained from legally authorized representatives. Therefore, individual patient informed consent for this study was not applicable, and a waiver of informed consent was obtained from the institutional review board of St. Paul’s Hospital Millennium Medical College.

The confidentiality of information collected from patient records was protected by making the data collection coded. Specific identifying information, such as patient name or chart number, was not included in this study, and all information was treated with utmost confidentiality.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was funded by a grant from St. Paul’s Hospital Millennium Medical College.