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Year : 2006  |  Volume : 9  |  Issue : 3  |  Page : 74-77

Use of clinical evauation in predicting endoscopic diagnosis of dyspepsia

Gastroenterology Unit/Department of Medicine, Aminu Kana University Teaching Hospital, Kana, Nigeria

Correspondence Address:
B M Tijjani
Department of Medicine, Aminu Kano University Teaching Hospital, P.M.B. 3452, Kano
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Background: The unavailability of endoscopy facilities in most Health Institutions in Nigeria as well as the lack/high cost of non-invasive screening tests for H. pylori makes evaluation and management of dyspepsia a difficult task . This study was undertaken to determine the sensitivity of presumptive clinical judgment in making diagnosis of the various causes of dyspepsia. Methods: The study was conducted between December 2002 and May 2004 .Two hundred and three adult dyspeptic patients referred to the gastroenterology unit of AKTH for endoscopy were recruited. Upper gastrointestinal endoscopy was performed on each patient using a fibre-optic Olympus GIF Q-40 forward viewing video endoscope and histological for presence of Helicobacter pylori was done using Haematoxylin and Eosin, and Eosin, and modified Geimsa stains. Results: The mean age of the study subjects was 37.7 + 13.5 years with the highest frequency in the 30-34 year age bracket, with a male to female ratio of 1 .16:1 . There was no significant association between sex and type of dyspepsia, P value > 0.05.There was also no significant association between type of dyspepsia and duration of dyspeptic symptoms (P value >0.05).Anorexia and weight loss were found to be significantly associated with presence of organic dyspepsia with P values < 0.05.Clinical evaluation was sensitive in predicting duodenal ulcer, gastric cancer and gastro-esophageal reflux disease but is fraught with over diagnosis and symptom overlap. Conclusions: Certain symptomatologies such as anorexia and weight loss may be pointers to underlying organic lesions for dyspepsia. However clinical evaluation alone is fraught with mis-diagnosis and symptom overlap.

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