Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. The
symptoms of causes of dyspepsia often overlap and this makes etiological diagnosis difficult. Endoscopy is the
ideal procedure for identifying organic diseases of the foregut.
Helicobacter pylori
infection is associated with
various upper gastrointestinal pathologies. A cross-sectional study was conducted to determine endoscopic
findings and
H. pylori status in two hundred and eight consecutive dyspeptic adult patients between June 2009
and April 2010 at Kilimanjaro Christian medical Centre, a referral and teaching hospital in northern Tanzania.
The most commonly identified endoscopic findings were gastritis (61.10%), Gastroesophageal reflux disease
(GERD) (57%), and Peptic ulcer disease (PUD) (24.1%). Gastric cancer was identified in 6.7 % of patients and all of
them were aged 40 years and above (p=0.00).
H. pylori infection was detected in 65% (n=130) of patients. H.
pylori infection was present in 57% (n=24) of patients who were tested within six months after eradication
therapy. Gastritis and duodenal ulcer were statistically significantly associated with
H. pylori (p<0.001). No
association was found between GERD and
H. pylori infection (p>0.05). Gastritis, GERD, and PUD are the leading
causes of dyspepsia.
H. pylori infection is present in significant proportion of dyspeptic patients. Patients with
Gastritis and PUD should undergo empirical eradication therapy if a confirmatory test is not available. Patients
with dyspepsia who are over 40 years of age should undergo Endoscopy (EGD) for initial work up. Study on
antimicrobial susceptibility pattern of
H. pylori is recommended to guide choices for evidence based treatment
option.
