PMID- 33877961
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20220423
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 56
IP  - 6
DP  - 2021 Jun
TI  - The yield of upper gastrointestinal endoscopy in patients below 60 years and 
      without alarm symptoms presenting with dyspepsia.
PG  - 740-746
LID - 10.1080/00365521.2021.1912168 [doi]
AB  - BACKGROUND AND AIMS: Upper gastrointestinal (GI) endoscopy is frequently 
      performed in patients with upper abdominal symptoms. Although guidelines 
      recommend withholding an endoscopy in the absence of alarm symptoms, dyspeptic 
      symptoms remain a predominant indication for endoscopy. We aimed to investigate 
      the yield of upper GI endoscopy in patients with low-risk dyspeptic symptoms. 
      METHODS: We conducted an analysis in a prospectively maintained endoscopy 
      reporting database. We collected the results of all upper GI endoscopy procedures 
      between 2015 and 2019 that was performed in adult patients aged <60 years with 
      dyspeptic symptoms. Patients with documented alarm symptoms were excluded. We 
      categorized endoscopic findings into major and minor endoscopic findings. 
      RESULTS: We identified 26,440 patients with dyspeptic symptoms who underwent 
      upper GI endoscopy. A total of 13,978 patients were considered low-risk and 
      included for analysis (median age 46 years, interquartile range (IQR) [36-53], 
      62% female). In 11,353 patients (81.2%), no endoscopic abnormalities were 
      detected. Major endoscopic findings were seen in 513 patients (3.7%) and minor 
      endoscopic findings in 2178 patients (15.6%). Endoscopic findings indicative of 
      upper GI cancer were reported in 47 patients (0.3%), including 16 (0.1%) 
      oesophageal, 28 (0.2%) gastric and 5 (0.04%) duodenal lesions. Despite an initial 
      unremarkable endoscopy result, 1015 of 11,353 patients (8.9%) underwent a 
      follow-up endoscopy after a median of 428 days [IQR 158-819]. This did not lead 
      to the additional identification of malignancy. CONCLUSIONS: The yield of upper 
      GI endoscopy in low-risk (<60 years, no alarm symptoms) patients with dyspepsia 
      is very limited. This study further supports a restrictive use of upper GI 
      endoscopy in these patients.
FAU - Theunissen, Felix
AU  - Theunissen F
AUID- ORCID: 0000-0002-5640-9134
AD  - Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, 
      The Netherlands.
FAU - Lantinga, Marten A
AU  - Lantinga MA
AUID- ORCID: 0000-0003-3137-901X
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Center, 
      Nijmegen, The Netherlands.
FAU - Borg, Pieter C J Ter
AU  - Borg PCJT
AD  - Department of Gastroenterology and Hepatology, Ikazia Ziekenhuis, Rotterdam, The 
      Netherlands.
FAU - Ouwendijk, Rob J T
AU  - Ouwendijk RJT
AD  - Department of Gastroenterology and Hepatology, ADRZ, Goes, The Netherlands.
FAU - Bruno, Marco J
AU  - Bruno MJ
AUID- ORCID: 0000-0001-9181-5499
AD  - Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, 
      The Netherlands.
FAU - Siersema, Peter D
AU  - Siersema PD
AUID- ORCID: 0000-0002-6940-8499
AD  - Department of Gastroenterology and Hepatology, Radboud University Medical Center, 
      Nijmegen, The Netherlands.
CN  - Trans IT Foundation Study Group
LA  - eng
PT  - Journal Article
DEP - 20210420
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
SB  - IM
MH  - Adult
MH  - *Dyspepsia/diagnosis
MH  - Endoscopy, Gastrointestinal
MH  - Female
MH  - *Gastrointestinal Neoplasms
MH  - Humans
MH  - Male
OTO - NOTNLM
OT  - Dyspeptic symptoms
OT  - dyspepsia
OT  - endoscopic outcomes
OT  - gastrointestinal malignancies
OT  - low-risk patients
OT  - upper gastrointestinal endoscopy
EDAT- 2021/04/21 06:00
MHDA- 2021/08/19 06:00
CRDT- 2021/04/20 17:16
PHST- 2021/04/21 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2021/04/20 17:16 [entrez]
AID - 10.1080/00365521.2021.1912168 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2021 Jun;56(6):740-746. doi: 
      10.1080/00365521.2021.1912168. Epub 2021 Apr 20.