SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 1 | 47 Bloody diarrhoea 0 0% 0 0% Colonoscopy Findings: Normal 4 9,5% 3 7,1% Haemorrhoids 3 7,1% 4 9,5% Poorly prepared 1 2,3% 3 7,1% Proctitis 3 7,1% 0 0% Lower-GI malignancy 1 2,3% 1 2,3% Colitis 0 0% 1 2,3% Diverticulitis 1 2,3% 0 0% There were positive associations noted on histology between: epigastric pain and gastritis (p=0.001) and dysphagia and oesophageal carcinoma (p<0.001) and loss of weight and oesophageal carcinoma (p=0.027). [Tables 14,15,16] Table 14: Histology findings in patients with epigastric pain Histology findings N Normal 4 Gastritis 6 Gastric ulcer 1 Gastric cancer 1 Oesophageal squamous cancer 1 Barrett’s oesophagus 1 Table 15: Histology findings in patients with Dysphagia Histology finding N Normal 3 Oesophageal squamous cancer 15 Adenoma 1 Oesophageal candidiasis 1 Oesophageal ulcer 1 Gastritis 1 Table 16: Histology findings in patients with loss of weight Histology findings N Gastric cancer 1 Oesophageal squamous cancer 4 Drug Associations One-fifth of the patients that presented with epigastric pain had a history of taking NSAIDS. [Tables 17&18] Just under one-quarter of patients with heartburn were taking calcium channel blockers. [Table 19] No positive associations were found between corticosteroid use or alcohol use and gastroscopy symptoms and findings. Associations with Age With regards to age groups, in the 40–59-year age group, the commonest finding was that of diffuse gastritis (38%) while in the 60–90-year age group oesophageal malignancy (87%) was the most frequent finding. The commonest presenting symptom for colonoscopy in the age group 20-39 vs.40-59 years was that of diarrhoea (16.6% vs 14.2%) while for the 60-90 age group it was constipation. In the age group 20-39 years haemorrhoids was the commonest finding. Over one-fifth of the patients who presented for colonoscopy were poorly prepared (9/42, 21.4%), this made full assessment difficult. Discussion It is estimated that around one-quarter (24.1%) of all gastroscopies and just over a third (35.5%) of lower endoscopic procedures that are performed globally, yield normal results. 4 These findings question the indications for performing such endoscopies. 6 It is understood that gastrointestinal symptoms can be nonspecific and can be poorly correlated with organic pathology found Table 17: NSAIDS and Indications for Gastroscopy Symptoms N % Epigastric Pain 22 20.7 Heart Burn 8 13.5 Dysphagia 7 11.8 Upper GI-bleed 5 15.1 Table 18: NSAIDS and Gastroscopy findings Findings N % Diffuse gastritis 18 12.6 Duodenitis 6 18.1 Hiatal hernia 7 15 Oesophagitis 4 9.5 Table 19: Calcium channel blockers and gastroscopy symptoms Symptoms N % Heartburn 14 23.7 Epigastric pain 8 5 Nausea and vomiting 3 9 CASE SERIES