The changing prevalence of upper gastrointestinal endoscopic diagnoses: a single-centre study

Abstract

Introduction: Upper gastrointestinal (GI) endoscopy is increasingly applied in daily practice. Not many data are available on yearly changes in diagnostic yield, nor on changes in morbidity.

Aim: To study the possible changes in occurrence of abnormalities in the oesophagus, stomach and duodenum.

Methods: All consecutive upper GI endoscopies performed over a period of 20 years were included. Important diagnoses were defined as: oesophagitis, metaplastic epithelium in the oesophagus, hiatal hernia or defective sphincter, ulcers, erosive or nodular gastritis, operated stomach, and cancer.

Results: In the 20-year period, 29,218 upper GI endoscopies were performed. 'Open-access' endoscopy, i.e. at the request of the general practitioner, showed a clear increase in the first ten years and remained stable thereafter. A trend towards an increase in macroscopic abnormalities was seen. The presence of hiatal hernia and defective sphincter showed a significant increase over 20 years, while the number of patients with reflux oesophagitis showed a less impressive, but still significant increase (p<0.001) in the first ten years and remained stable thereafter. There was an impressive decrease in the incidence of peptic ulcer disease. Prevalence of oesophageal cancer showed a gradual increase, although the numbers were very low.

Conclusions: In a period of 20 years the diagnostic yield of upper GI endoscopy showed significant changes. Reflux disease increased in prevalence while peptic ulcer disease decreased.