ENDOSCOPIC FINDINGS IN PATIENTS PRESENTING WITH OESOPHAGEAL DYSPHAGIA
AbstractBackground: Dysphagia is the difficulty in swallowing and is often described by the patients as a ‘perception’ that there is an impediment to the normal passage of the swallowed material. It is frequently observed that there is an association of dysphagia with serious underlying disorders and warrants early evaluation. The current study aimed to determine the frequency of common endoscopic findings in patients presenting with oesophageal dysphagia. Methods: This cross-sectional descriptive study was carried out in the department of Gastroenterology, Ayub Medical College, Abbottabad, from October 2012 to April 2013. Consecutive patients with dysphagia were included in the study and were subjected to endoscopy. Results: A total of 139 patients presenting with dysphagia were studied, 81 (58.3%) were males and 58 (41.7%) were females. The mean age was 52.41±16.42. Malignant oesophageal stricture was the most common finding noted in 38 (27.3%) patients with 28 (73.7%) males and 23 (60.5%) patients among them were above the age of 50years. It was followed by normal upper Gastrointestinal (GI) endoscopy in 29 (20.9%) patients and reflux esophagitis in 25 (18.0%) patients. Schatzki’s ring was present in 14 (10.1%) patients; benign oesophageal strictures in 12 (8.6%) patients while achalasia was noted in 7 (5.0%) patients. 14 (10.1%) patients had findings other than the ones mentioned above. Conclusion: Malignancies are a more common cause of dysphagia in our population and early diagnosis can result in proper treatment of many of these cases.Keywords: Endoscopy, dysphagia, malignancy, reflux esophagitis, Schatzki’s ring, achalasia
Eslick GD, Talley NJ. Dysphagia: epidemiology, risk factors and impact on quality of life--a population-based study. Aliment Pharmacol Ther. 2008;27:971–9
McQuaid KR. Gastrointestinal disorders. In: McPhee SJ, Papadakis MA, editors. Current Medical Diagnosis and Treatment, 50th edition. New York: McGraw-Hill. 2011: p568–9
Cecconi E, Di Piero V. Dysphagia-pathophysiology, diagnosis and treatment. Front Neurol Neurosci. 2012;30:86–9.
Saitoh E. Dysphagia rehabilitation. Rinsho Shinkeigaku. 2008;48:875-9
Vent J, Preuss SF, Eslick GD. Dysphagia as a cause of chest pain: An otolaryngologist’s view. Med Clin N Am. 2010;94:243–57.
Wilkins T, Gillies RA, Thomas AM, Wagner PJ. The prevalence of dysphagia in primary care patients: a Hames Net Research Network study. J Am Board Fam Med. 2007;20:144–50
Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008;19:853–66
Ahmad I, Atif MA, Mustafa G. Upper gastrointestinal endoscopy: Indications and outcome experience at Sheikh Zayed Hospital Rahim Yar Khan. J Sheikh Zayed Med Coll. 2010;1:27–9
Palmer KR, Penman ID. Alimentary tract and pancreatic diseases. In: Colledge NR, Walker BR, Ralston SH, editors. Davidson’s principles and practice of medicine. 21st edition. Edinburgh: Churchill Livingstone. 2010: p850.
Gilani N, Stipho S, Shaukat MS, Akins R, Ramirez FC . The yield and safety of string capsule endoscopy in patients with dysphagia. Gastrointest Endosc. 2007;66:1091–5
Krishnamurthy C, Hilden K, Peterson KA, Mattek N, Adler DG, Fang JC. Endoscopic findings in patients presenting with dysphagia: analysis of a national endoscopy database. Dysphagia. 2012;27:101–5
Malagelada JR, Bazzoli F, Elewaut A, Fried M, Krabshuis JH, Lindberg G. World Gastroenterology Organization Practice Guidelines: Dysphagia 2007 p:27
Qureshi NA, Hallissey MT, Fielding JW. Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review. BMC Gastroenterol. 2007; 7:43
Majeski J, Lynch W, Durst G. Esophageal perforation during esophagogastroduodenoscopy. Am J Surg. 2009;198:56-7
Kidambi T, Toto E, Ho N, Taft T, Hirano I. Temporal trends in the relative prevalence of dysphagia etiologies from 1999-2009. World J Gastroenterol. 2012;18(32): 4335–41
Satti SA, Ahmed SI, Habib M, Naseemullah M. Flexible Oesophagoscopy in oesophageal dysphagia: A 134 Patient Series. J Rawal Med Coll 2002;6(1):26–9
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