Diagnostic Yield of Upper Gastrointestinal Endoscopy with reference to Barrett’s Esophagus in a Tertiary Care Center in Indiaadmin
Upper gastrointestinal (GI) endoscopy is a common diagnostic procedure that plays central role in gastroenterology. It is a safe, accurate open access investigation for evaluation of wide range of upper GI lesions. The study was aimed to know the diagnostic yield of upper GI endoscopy in patients with GI symptoms. We focused to investigate the prevalence, clinical features, risk factors and endoscopic findings of Barrett’s Esophagus (BE) in the studied cohort.
Material and methods:
A total of 3000 subjects underwent diagnostic upper GI endoscopy over last 1 year with variety of GI symptoms and indications. Demographic data including age, sex, personal habits, past medical history, comorbidities were recorded. Results: Mean age of the patients is 51.6+/- 32.8 years ranging from 13 to 81 years. 63% were male and 37% were female. Out of 3000 patients, 63 patients had BE (2.1%) with symptoms of Gastro Esophageal Reflux Disease (GERD). 65% of BE subjects were smokers, 25% alcoholic and 32% were tobacco chewers. Out of 63 patients with BE on endoscopic evaluation, 51 had non-dysplastic BE while 10 had low grade and 2 had high-grade dysplasia. 5 of BE patients had hiatus hernia. We diagnosed BE on macroscopic examination during endoscopy and it was found to be non-dysplastic type of BE.
Conservative management was offered to the patients with non-dysplastic BE. It involved symptomatic treatment and periodic endoscopic surveillance to assess the progression of the disease. As BE is a predisposing factor for Esophageal Adenocarcinoma (EAC), early identification of high risk individuals and implementation of preventive strategy will help to reduce prevalence of EAC.
There is 2.1% frequency of BE among GI symptomatic patients. GERD, smoking, tobacco and alcohol consumption are identified risk factors in our studied population.