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 23 April 2018

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Pathology predictors in upper endoscopy for dysphagia evaluation

Upper endoscopy is appropriate for initial evaluation of patients presenting with dysphagia, and should be considered in male patients over 40 years who report heartburn, odynophagia, or weight loss, finds the most recent Gastrointestinal Endoscopy.

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The utility of upper gastrointestinal endoscopy when used as an initial test for the evaluation of dysphagia is unclear.

Dr Varadarajulu and colleagues determined the yield and the predictive factors of significant pathology when upper gastrointestinal endoscopy is performed as the initial test to evaluate dysphagia.

The researchers conducted a retrospective analysis of a computerized database.

Cancer was found in 4% of patients, predicted by male gender, age, and weight loss.
Gastrointestinal Endoscopy

The research team retrieved data on patients who underwent upper gastrointestinal endoscopy for dysphagia from the endoscopy database of 6 endoscopy units.

Patients who had undergone prior esophageal evaluation, failed upper gastrointestinal endoscopy, or who had a history of prior upper-gastrointestinal pathology were excluded.

The team performed univariate and multivariable logistic regression analyses to evaluate any relation between endoscopic findings and presenting clinical features.

The researchers analyzed a total of 1649 patients with dysphagia and a mean age 57 years.

Abnormal findings at upper gastrointestinal endoscopy were found in 70% of the patients, and a major pathology was seen in 54%.

The researchers found that male gender, heartburn, and odynophagia predicted the presence of major pathology.

The team observed cancer in 4% of patients, which was predicted by male gender, age, and weight loss.

The esophagus was normal in 29% of patients and was predicted by female gender and the absence of heartburn, but not age.

The researchers reported that there was a lack of details on patients' presentation and clinical history and an absence of long-term clinical follow-up.

Dr Varadarajulu's team concludes, “Upper gastrointestinal endoscopy is an effective and an appropriate tool for the initial evaluation of patients presenting with dysphagia.”

“Early upper gastrointestinal endoscopy should be considered, particularly, in male patients aged more than 40 years old who concomitantly report heartburn, odynophagia, or weight loss.”

Gastrointest Endosc 2005: 61(7)
07 June 2005

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