Korean J Gastrointest Endosc > Volume 22(1); 2001 > Article

Korean Journal of Gastrointestinal Endoscopy 2001;22(1): 1-7.

한국인 소화불량 환자 중 어느환자에서 내시경 검사를 할 것인가? ( Dyspepsia in Korean Population: Who Needs Endoscopy? )

이준호(Jun Ho Lee),김학양(Hak Yang Kim),노승혁(Seung Hyuck Rho),윤덕형(Duck Hyong Yoon),김경호(Kyung Ho Kim),이자영(Ja Young Lee),최종형(Jong Hyung Choi),김억(Auk Kim),이진헌(Jin Heon Lee),김용범(Yong Bum Kim),유재영(Jae Young Yoo)

Abstract

Background/Aims:
Dyspepsia is remarkably common in the general population. Although upper gastrointestinal endoscopy is the investigation of choice for dyspepsia, the selection of the patients who need endoscopy is very difficult. This study was aimed to investigate the usefulness of the various parameters for the selection of the patients who need endoscopy in Korean population,
Methods:
An analysis of the endoscopic findings was carried out in 141 patients with dyspepsia according to parameters including H. pylori IgG seropositivity, age and alarm signs, such as dysphagia, weight loss, vomiting, anemia, family history of upper gastrointestinal malignancy, hematemesis or melena, abdominal mass and anorexia.
Results:
The positive rates of stomach cancer and peptic ulcer in patients above 35 years of age were 3% (4/118) and 30% (35/118), respectively. The positive rates of stomach cancer and peptic ulcer in patients with alarm signs were 2% (2/94), 36% (34/94) and the rates in patients with H. pylori IgG seropositivity were 4% (3/70), 37% (26/70), respectively. However, no parameter was useful in the selection of patients with stomach cancer or peptic ulcer. In patients with alarm signs, the positive rates of peptic ulcer in patients with and without H. pylori IgG seropositivity were 46% (22/48) and 26% (12/46), respectively (p=0.04). In patients under 35 years of age, the positive rates of peptic ulcer in patients with and without H. pylori IgG seropositivity were 58% (7/12) and 18% (2/11), respectively (p=0.048).
Conclusions:
The overall positive rates of stomach cancer or peptic ulcer were significantly higher in patient group with both H. pylori IgG seropositivity and alarm signs, and that under 35 years of age with H. pylori IgG seropositivity. However, there were also considerable number of peptic ulcer in patients who were excluded from those groups. We recommend that those parameters should be used only as a decision aid in selecting the candidates for endoscopy. (Korean J Gastrointest Endosc 2001;22:1 - 7)

Key Words: Dyspepsia, Endoscopy, Age, Alarm sign, Helicobacter pylori