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Observational Study
. 2015 Jan 14;21(2):637-43.
doi: 10.3748/wjg.v21.i2.637.

Performance of American Society for Gastrointestinal Endoscopy guidelines for dyspepsia in Saudi population: prospective observational study

Nahla A Azzam  1 , Majid A Almadi  1 , Hessah Hamad Alamar  1 , Lamis Atyah Almalki  1 , Rehab Nawaf Alrashedi  1 , Rawabi Saleh Alghamdi  1 , Waleed Al-hamoudi  1
Affiliations
Observational Study

Performance of American Society for Gastrointestinal Endoscopy guidelines for dyspepsia in Saudi population: prospective observational study

Nahla A Azzam et al. World J Gastroenterol. .

Abstract

Aim: To evaluate adherence of primary care physicians (PCPs) to international guidelines when referring patients for upper-gastrointestinal endoscopy (UGE), evaluate the importance of alarm symptoms and the performance of the American Society for Gastrointestinal Endoscopy (ASGE) guidelines in a Saudi population.

Methods: A prospective, observational cross-sectional study on dyspeptic patients undergoing UGE who were referred by PCPs over a 4 mo period. Referrals were classified as appropriate or inappropriate according to adherence to ASGE guidelines.

Results: Total of 221 dyspeptic patients was enrolled; 161 patients met our inclusion criteria. Mean age was 40.3 years (SD ± 18.1). Females comprised 70.1%. Alarm symptoms included low hemoglobin level (39%), weight loss (18%), vomiting (16%), loss of appetite (16%), difficulty swallowing (3%), and gastrointestinal bleeding (3%). Abnormal endoscopy findings included gastritis (52%), duodenitis (10%), hiatus hernia (7.8%), features suggestive of celiac disease (6.5%), ulcers (3.9%), malignancy (2.6%) and gastroesophageal reflux disease (GERD: 17%). Among patients who underwent UGE, 63% met ASGE guidelines, and 50% had abnormal endoscopic findings. Endoscopy was not indicated in remaining 37% of patients. Among the latter group, endoscopy was normal in 54% of patients. There was no difference in proportion of abnormal endoscopic findings between two groups (P = 0.639).

Conclusion: Dyspeptic patients had a low prevalence of important endoscopic lesions, and none of the alarm symptoms could significantly predict abnormal endoscopic findings.

Keywords: American Society for Gastrointestinal Endoscopy guideline; Dyspepsia; Primary care physician; Saudi population; Upper gastrointestinal endoscopy.

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Figures

Figure 1
Figure 1
The distribution of abnormal endoscopic finding for the cohort.
See this image and copyright information in PMC

References

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