Vol. 3 No. 2 (2020): Open Journal of Gastroenterology and Hepatology
Research Articles

UPPER GASTROINTESTINAL ENDOSCOPY IN IDO-EKITI, NIGERIA: A FOUR-YEAR REVIEW

Oguntoye Oluwatosin Oluwagbenga1, Yusuf Musah1, Olowoyo Paul1, Erinomo Olagoke2, Omoseebi Oladipo2, Soje Michael Osisiogu1, Oguntoye Oluwafunmilayo Adenike3, Oguntade Hameed Banjo3, Ariyo Olumuyiwa Elijah3, Atolani Segun Alex3
1Department of Internal Medicine, Federal Teaching Hospital Ido-Ekiti and Afe Babalola University Ado-Ekiti, Nigeria.2Department of Morbid Anatomy, Federal Teaching Hospital Ido-Ekiti and Afe Babalola University Ado-Ekiti, Nigeria.3Department of Internal Medicine, Federal Teaching Hospital Ido-Ekiti, Nigeria.
Keywords
  • Endoscopy, Findings, Gastrointestinal, Indications, Nigeria, Oesophagogastroduodenoscopy.
How to Cite
Oguntoye Oluwatosin Oluwagbenga1, Yusuf Musah1, Olowoyo Paul1, Erinomo Olagoke2, Omoseebi Oladipo2, Soje Michael Osisiogu1, Oguntoye Oluwafunmilayo Adenike3, Oguntade Hameed Banjo3, Ariyo Olumuyiwa Elijah3, Atolani Segun Alex3. (2020). UPPER GASTROINTESTINAL ENDOSCOPY IN IDO-EKITI, NIGERIA: A FOUR-YEAR REVIEW. Open Journal of Gastroenterology and Hepatology, 3(2), 35. https://doi.org/10.28933/ojgh-2020-04-0905

Abstract

Background: Upper gastrointestinal complaints are common, and the underlying diseases varies widely. Upper gastrointestinal endoscopy is the gold standard investigation for upper gastrointestinal symptoms. It helps in the proper diagnosis and the appropriate management of the underlying lesions.

Aim: To determine the characteristics of the patients undergoing upper gastrointestinal endoscopy in a rural community in south-western Nigeria.

Methods: This was a retrospective cohort study of all patients who had upper gastrointestinal endoscopy between February 2016 and February 2020 (a period of 4 years). The Age, Gender, Indication and the Endoscopy findings were obtained from the Endoscopy Register. A total of 181 upper gastrointestinal endoscopies had been performed over the period. The data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics used included frequency tables, means and standard deviations.

Results: A total number of 181 Oesophagogastroduodenoscopies (OGDs) were performed during the period under review, out of which 95 (52.5%) were males and 86 (47.5%) were females with a male to female ratio of 1.1 to 1. The age range of the patients was 9 to 89 years with a mean(±SD) of 52.4(±1.69) and median of 52.0 years. The highest number of OGDs were performed on individuals within the age bracket of 50-59 years whom were mostly females.

Dyspepsia constituted the commonest indication for OGD (51.9%) followed by symptoms of upper gastrointestinal bleeding (haematemesis/melaena) 16.0%, unexplained persistent vomiting 6.6% and clinical suspicion of a gastric tumour 5.5%.

The commonest endoscopic abnormality detected from this study was Gastritis 28.2% followed by Gastric erosions 12.2%, Duodenal ulcers 8.8%, Gastric tumours 8.3% and Oesophagitis 7.2%. Normal endoscopy findings were found in 24.9% of the patients. Gastritis was also the commonest endoscopic finding (constituting 40.4%) in patients who had OGD done on account of dyspepsia followed by Duodenal ulcers (8.5%) and Gastric erosions (6.4%). Gastric erosions constituted the commonest cause of upper gastrointestinal bleeding in this study (44.8%) followed by Duodenal ulcers (13.8%).

Conclusion: The commonest indication for upper gastrointestinal endoscopy in this study was dyspepsia while the commonest endoscopic diagnosis was gastritis. Gastric erosion was most commonly seen in patients with upper gastrointestinal bleeding. From this study, Acid-Peptic disorders were the commonest underlying gastrointestinal pathologies of patients’ symptomatology necessitating endoscopic evaluation. The findings from this study conducted in a rural community in Nigeria were similar to those conducted in urban communities in the country. Therefore, a national guideline on the endoscopic evaluation of upper gastrointestinal disorders can be universally applied irrespective of the location of practice in Nigeria.

References

  1. Yusuf T.E., Bhutani M.S. Oesophagogastro-duodenoscopy. https://emedicine.medscape.com/article/1851864-overview#a1. Updated: March 02,2020. Assessed: April 06,2020.
  2. Tytgat G.N.J. Role of endoscopy and biopsy in the work up of dyspepsia. Gut 2002;50 (Suppl IV):iv 13-iv 16.
  3. Ray-Offor E., Obiorah C.C. Upper gastrointestinal endoscopy in Port harcourt, Nigeria: An audit. The Nigerian Health Journal2014;14 (3): 134-139.
  4. Early D.S., Ben-Menachem T., Decker G.A. (Communication from the American Association for Gastrointestinal Endoscopy (ASGE) Standards of Practice Committee). Appropriate use of gastrointestinal endoscopy. Endoscopy 2012;75:1127-1131.
  5. Wolf L.L., Ibrahim R., Miao C., Muyco A., Hosseinipour M.C., Shores C. Esophagogastroduodenoscopy in a public referral hospital in Lilongwe, Malawi: Spectrum of disease and associated risk factors. World J Surg 2012;36:1074-1082.
  6. Aduful H., Naaeder S., Darko R., Baako B., Clegg-Lampley J., Nkrumah K. et al. Upper gastrointestinal endoscopy at the korle bu teaching hospital, accra, ghana. Ghana Med J 2007; 41(1):12-16.
  7. Nkrumah K.N. Endoscopic evaluation of upper abdominal symptoms in adult patients in Saudi Aramco-Ai Hasa Health center, Saudi Arabia. West African Journal of Medicine 2002; 21(1):1-4.
  8. Khurram M., Khaar H.T., Hasan Z., Umar M., Javed S., Asghar T., et al. A 12 year audit of upper gastrointestinal endoscopic procedures. Journal of the College of Physicians and Surgeons- Pakistan. JCPSP 2003; 13(6):321-324.
  9. Malu A.O., Wali S.S., Kazmi R., Macauley D., Fakunle Y.M. Upper gastrointestinal endoscopy in Zaria, northern Nigeria. West Afr J Med 1990;9:279-284.
  10. Danbauchi S.S., Keshinro I.B., Abdu-Gusau K. Fifteen years of upper gastrointestinal endoscopy in Zaria (1978-1993). Afr J Med Med Sci 1999;28:87-90.
  11. Abakwuru E.A., Fatusi A.O., Ndububa D.A., Alatise O.I., Arigbabu O.A., Akinola D.O. Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in South-West Nigeria. Afr Health Sci 2006;6:98-103.
  12. Ndububa D.A., Agbakwuru A.E., Adebayo R.A., Olasode B.J., Olaomi O.O., Adeosun O.A., et al. Upper gastrointestinal findings and incidence of Helicobacter pylori infection among Nigerian patients with dyspepsia. West Afr J Med 2001;20:140-145.
  13. Onyekwere C.A., Hameed H., Anomneze E.E., Chibututu C. Upper gastrointestinal endoscopy findings in Nigerians: A review of 170 cases in Lagos. Niger Postgrad Med J 2008;15:126-129.
  14. Mustapha S.K., Kida I.M., Dayar A., Gundiri L.B. Indications for gastrointestinal endoscopy in Maiduguri, North Eastern Nigeria. BOM J 2010;7:16-18.
  15. Olokoba A.B., Bojuwoye B.J. Indications for oesophagogastroduodenoscopy in Ilorin, Nigeria – A 30 month review. Niger J Clin Pract 2010;13:260-263.
  16. Jeje E., Olajide T., Akande B. Upper gastrointetinal endoscopy – Our findings in Lagoon Hospital, Lagos, Nigeria. Macedonian J Med Sci 2013;6:168-173.
  17. Ismaila B.O., Misauno M.A. Gastrointestinal endoscopy in Nigeria – A prospective two year audit. Pan Afr Med J 2013;14:22.
  18. Picardo N.G., Ajayi N.A. Indications for an endoscopic findings in patients with symptoms of upper gastrointestinal disease in a Tertiary Hospital in South-Eastern Nigeria. Afr J Med Health Sci 2015;14:96-100.
  19. Olokoba A.B., Olokoba L., Jimoh A. et al. Upper gastrointestinal tract endoscopy indications in Northern Nigeria. Journal of the College of Physicians and Surgeons–Pakistan: JCPSP 2009; 19(5):327-328.
  20. Gyedu A., Yorke J. Upper gastrointestinal endoscopy in the patient population of Kumasi, Ghana: Indications and findings. Pan Afr Med J 2014;18:327.
  21. Al-Romaih W.R., Al-Shehri A.M. Appropriateness of upper gastrointestinal endoscopy referrals from primary health care. Ann Saudi Med 2006;26:224-227.
  22. Dakubo J.C., Clegg-Lamptey J.N., Sowah P. Appropriateness of referrals for upper gastrointestinal endoscopy. West Afr J Med 2011;30:342-347.
  23. Tachi K., Nkrumah K.N. Appropriateness and diagnostic yield of referrals for oesophagogastroduodenoscopy at the Korle Bu Teaching Hospital. West Afr J Med 2011;30:158-163.
  24. Nwokediuku S., Omuemu C., Akere A. Guidelines for the management of dyspepsia and gastroesophageal reflux disease. Nigerian Journal of Gastroenterology and Hepatology 2015; 7(2):93-108.
  25. Suerbaum S., Michetti P. Helicobacter pylori infection. N Engl J Med. 2002; 347 (15):1175-1186.
  26. Hameed L., Onyekwere A.C., Otegbayo J.A., Abdulkareem F.B. A clinicopathological study of dyspeptic subjects in Lagos, Nigeria. Gastroenterol Insights 2012;4:e11.
  27. Jemilohun A.C., Otegbayo J.A., Ola S.O., Oluwasola O.A., Akere A. Prevalence of helicobacter pylori among Nigerian patients with dyspepsia in Ibadan. Pan African Medical Journal 2011; 6:18-25.
  28. Solomon O.A., Ajayi A.O., Adegun P.T., Gabriel O.E., Afolabi O., Solomon O.O. Effectiveness of Triple Therapy Regimens in the Eradication of Helicobacter pylori in Patients with Uninvestigated Dyspepsia in Ekiti State, Nigeria. British Journal of Medicine & Medical Research 2015; 6(3): 278-285.
  29. Suerbaum S., Michetti P. Helicobacter pylori infection. N Engl J Med. 2002;347:1175–1185.