SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 1 | 43 (iii) Symptoms: dysphagia, nausea and vomiting, abdominal pain, diarrhoea, water-brash dyspepsia, loss of weight, haematemesis, melaena, anaemia (iv) Drug History: Use of any form of non-steroidal anti-inflammatories or corticosteroids, antacids, H2- antagonists, proton pump inhibitors, bisphosphonates, calcium channels blockers, theophylline, antiretroviral therapy. (v) Co-morbidities: Ischaemic heart disease, HIV infection, CD4 and viral load, liver disease, asthma (vi) Gastroscopy findings (vii) Histology findings (viii) Treatment initiated (ix) Complications noted Data analysis Data was analysed by Intercooled Stata version 15. The level of significance was set at p<0.05.Variables were expressed as mean ±standard deviation or medians (interquartile range IQR) as appropriate. Mean ±standard deviation was compared using the Pearson chi-square test. Proportions and categorical variables were compared using the Fisher’s exact test. Sample size Over twenty thousand patients (20163) were referred for endoscopy at EDH between 01 January 2017 and December 2018. Those meeting the inclusion criteria were selected from the cohort of 20163 patient files for a retrospective chart review. The sample size of 350 patients was statistically deemed appropriate for a retrospective chart review, to be obtained by systemic random selection of every 6th patient file. Eight (8) of these randomly selected patients were excluded as a result of them being less than 18 years of age. Ethics Considerations Regulatory approvals were obtained from the University of KwaZulu Natal (UKZN) Biomedical Research Ethics Committee (BREC 520/19) [Appendix III]. Approval was also obtained from the KwaZulu Natal Department of Health and from Edendale Hospital. Results Endoscopy results of 342 patients were analysed, of which three hundred (300, 87.72%) had gastroscopies while forty-two (42, 12.28%) had colonoscopies performed. Twenty patients (5.85%) had both gastroscopy and colonoscopy procedures performed. Only one patient (1/342, 0.29%) had a complication- (adverse reaction to sedation). Over half of the patients (199/342, 58.19%) were females. The ages of patients ranged widely from 18 years to 90 years with the reported median age being 52 years. The majority of patients (332/342, 97.08%) were black South African, with (7/332, 2.05%) Caucasians and (3/332, 0.87%) which included the Indian and Coloured populations. A smoking history was elicited in 7% of patients. Over one-fifth of the patients (74/342, 21.6%) were HIV positive, of these HIV infected patients more than one- quarter underwent colonoscopy (12/42,28.5%) and one- fifth (62/300, 20%) underwent gastroscopy. Other common comorbidities found in patients undergoing endoscopies are listed in Table 1. Table 2 demonstrates that epigastric pain was the commonest indication for upper-GI scope. Other common symptoms reported were that of dysphagia and heartburn. Table 1. : Common comorbidities of patients Undergoing Endoscopies Frequency Percentage% HIV Infection 74 21.6 Osteoarthritis 20 5.84 Ischaemic heart disease 7 2.04 Asthma 5 1.4 Renal disease 5 1.4 Poison ingestion 9 2.6 Chronic liver disease 1 0.29 Table 2: Frequency of Symptoms Described by Patients Undergoing Upper Gastroscopy Symptoms Number of cases (N=300) Percentage (%) Epigastric pain 106 35.3% Dysphagia 59 19.67% Heartburn 59 19.67% Nausea and vomiting 33 11% Upper GI-bleed 33 11% Anaemia 25 8.3% Loss of weight 13 4.35% Abdominal pain 13 4.35% Maelena stools 5 1.67% Vomiting 5 1.67% Hoarse voice 4 1.33% Diarrhoea 4 1.33% Dyspepsia 3 1.00% Abdominal mass 1 0.33% Nausea 1 0.33% CASE SERIES