Epidemic Trends of Upper Gastrointestinal Tract Abnormalities: Hospital-based study on Endoscopic Data Evaluation

  • Published : 2015.09.02


Purpose: To understand the epidemiology of different upper gastrointestinal (UGI) tract related abnormalities through endoscopic data analysis. Materials and Methods: A retrospective study of three years from January 2009 to December 2011 was conducted with data from endoscopic surveillance of upper GI tract problems, collected from the Gastroenterology Unit, Osmania General Hospital, Hyderabad. MS excel and Medcalc software (comparison of proportions) were used for data analysis. Results: A total of 10,029 (6,468 in males and 3,561 in females) endoscopies were performed during this three-year period. The male to female ratio was 1.8:1. Overall, ~30% of endoscopies evaluated showed patients with acid peptic disorders, 13.6% with vascular-related abnormalities, 10.6% showed structural abnormalities, followed by 6.3% with malignancies. Burden of malignancies was mostly observed in the older age group (60-69 years). Esophageal cancer cases decreased (p=0.0001) whereas stomach cancers increased over this period (p=0.0345). We also observed an increased incidence of acid peptic disease (APD) (p=0.0036) and gastroesophageal reflux disease (GERD) (p=0.0002) cases during this period. Conclusions: Endoscopic diagnosis is useful for early detection of UGI anomalies and helpful for physicians to manage and treat varied kinds of UGI disorders. Analysis of data revealed changing trends in the incidence of various pathologies of the UGI tract. Functional dyspepsia and GERD definitely reduce the quality of life of the individual. The role of our diverse dietary habits and lifestyle associated with these problems have not yet been established, though there have been reports on the effect of coffee, spicy food, wheat-based diet, screening of UGI pathologies along with collection of complete personal and medical history details, can h elp in correlating the patients' condition with various aspects of lifestyle and diet.


  1. Acid Peptic Disease - Causes Symptoms Complications Diagnosis Treatment.
  2. Aduful HK, Naaeder SB, Darko R, et al (2007). Upper Gastrointestinal endoscopy at the Korle Bu Teaching Hospital, ACCRA, Ghana. Ghana Med J, 41.
  3. Andreollo NA, Lopes LR, Tercioti V Jr, Brandalise NA, Leonardi LS (2003). Barrett's esophagus associated to caustic stenosis of the esophagus. Arq Gastroenterol, 40, 148-51.
  4. Anjum M, Reddy P, Monica M, Yadav K, Abbas I, Kanakamedala S (2014). Dental Students attitude towards tobacco cessation in and around the dental colleges of Hyderabad-A cross sectional survey. Webmed Central Dent, 5, 4730.
  5. Axon ATR, Bell GD, Jones RH, Quine MA, McCloy RF (1995). Guidelines on appropriate indications for upper gastrointestinal endoscopy. BMJ, 310, 853-56.
  6. Bemeur C, Desjardins P, Butterworth RF (2010). Role of nutrition in the management of hepatic encephalopathy in end-stage liver failure. J Nutr Metab, 2010; 489823.
  7. Calderone RA, Fonzi WA (2001). Virulence factors of Candida albicans. Trends Microbiol, 9, 327-35.
  8. Cam S (2014) Risk of Gastric Cancer in Children with Helicobacter pylori Infection. Asian Pac J Cancer Prev, 15, 9905-08.
  9. Chava S, Kaliq MD, Nagarjuna P, et al (2011). Epigenetics and esophageal cancer: role of altered methylation in specific genes. Int J Cancer Res, 7, 233-43.
  10. David AL, Patricia LDEG, David EF, Glenn ME, Mark H (2000). Patterns of endoscopy use in the united states. Gastroenterol, 118, 619-24.
  11. Edgarachkar. Structural Disorders of the Esophagus (2005). Cleveland clinic foundation.
  12. Fatemi SR, Safaee A, Pasha S, et al (2014). Evaluation of endoscopic characteristics of upper gastrointestinal polyps in patients with familial adenomatous polyposis. Asian Pac J Cancer Prev, 15, 6945-48.
  13. Garg S, Garipelly R, Nagappa AN, Mateti UV (2013). Evaluation of attitude, behavior, knowledge, and smoking rates among youngsters from Southern India: a survey?based study from andhra pradesh, Int J Stud Res, 3, 35-41.
  14. G N J Tytgat (2002). Role of endoscopy and biopsy in the work up of dyspepsia. Gut, 50, 13-16.
  15. Ha NC, Oh ST, Sung SY, Cha KA, Lee MH, Oh B (2001). Supramolecular assembly and acid resistance of Helicobacter pylori urease. Nat Struct Biol, 8, 505-9.
  16. Howell, E. Enzyme Nutrition: The Food Enzyme Concept 1986. Twin Lakes, WI: Lotus Press.
  17. Ibrahim H, Awadalla (2013). Health effect of slums: A consequence of urbanization. SJM, 3, 7-14.
  18. Islami F, Kamangar F (2008). Helicobacter pylori and esophageal cancer risk- a metaanalysis. Cancer Prev Res (Phila),1, 329-38.
  19. Jainan W, Ratha-Korn (2014). Vilaichone effects of the cyp2c19 genetic polymorphism on gastritis, peptic ulcer disease, peptic ulcer bleeding and gastric cancer. Asian Pac J Cancer Prev, 15, 10957-60.
  20. John FM, Mark R (1991). Gastrointestinal Endoscopy. N Engl J Med, 325, 1142-49.
  21. Kaur J, Jain DC (2011). Tobacco control policies in India: implementation and challenges. Indian J Public Health, 55.
  22. Khan Y, Mohanty SK, Kumar H, Pandey S (2014). Upper gastro instestinal endoscopic findings in patients with dyspepsia: our experience at cims, bilaspur, chhattisgarh, India. IOSRJDMS, 13, 8-12.
  23. Khoshbaten M, Naderpour M, Mohammadi G, et al (2010). Epidemiology of esophageal lesions in patients with head and neck squamous cell carcinoma. Asian Pacific J Cancer Prev, 11, 863-65.
  24. Kurata JH, Nogawa AN (1997). Meta-analysis of risk factors for peptic ulcer. nonsteroidal antiinflammatory drugs, helicobacter pylori, and smoking. J Clin Gastroenterol, 24, 2-17.
  25. Messner AH, Browne JD, Geisinger KR (1996). Effect of intermittent acid and pepsin exposure on burned esophageal mucosa. Am J Otolaryngol, 17, 45-9.
  26. Michael LK (2007). The Future Use of Endoscopy in Therapeutic Procedures. Gastroenterol Hepatol, 3, 829-31.
  27. Mohiuddin MK, Chava S, Upendrum P, et al (2013). Role of Human papilloma virus infection and altered methylation of specific genes in esophageal cancer. Asian Pac J Cancer Prev, 14, 4187-93.
  28. Moore M, Gould P, Keary BS (2003). Global urbanization and impact on health. Int J Hyg Environ Health, 206, 269-278.
  29. Olokoba AB, Bojuwoye BJ (2010). Indications for oesophagogastroduodenoscopy in Ilorin, Nigeria a 30 month review. Niger J Clin Pract, 13, 260-263.
  30. Pahwa R, Neeta, Kumar V, Kohli K (2010). Clinical manifestations, causes and management strategies of peptic ulcer disease. IJPSDR, 2, 99-106.
  31. Saha AK, Maitra S, Hazra SC (2013). Epidemiology of gastric cancer in the gangetic areas of west bengal. ISRN Gastroenterol, 2013, 823483
  32. Seifert E, Gail K, Weismuller J (1983). Gastric polypectomy: long-term results (survey of 23 centres in Germany). Endoscopy, 15, 8-11.
  33. Smoot DT, Mobley HLT, Chippenale GR, Lewison JF, Resau JH (1990). Helicobacter pylori urease activity is toxic to human gastric epithelial cells. Infect Immunity, 58, 1992-94.
  34. Thomas V, Jose T, Kumar S (2009). Natural history of bleeding after esophageal variceal eradication in patients with extrahepatic portal venous obstruction; a 20-year follow-up. Indian J Gastroenterol, 28, 206-11.
  35. Tseng YL, Wu MH, Lin MY, Lai WW (2004). Massive upper gastrointestinal bleeding after acid-corrosive injury. World J Surg, 28, 50-54.
  36. Vannarath S, Vilaichone R, Rasachak B, et al (2014). Virulence Genes of Helicobacter pylori in Gastritis, Peptic Ulcer and Gastric Cancer in Laos. Asian Pac J Cancer Prev, 15, 9027-31.
  37. Vazquez JA, Sobel JD (2002). Mucosal candidiasis. Infect Dis Clin North Am, 16, 793-820.
  38. Whiteman DC, Parmar P, Fahey P, et al (2010). Association of helicobacter pylori infection with reduced risk for esophageal cancer is independent of environmental and genetic modifiers. Gastroenterol, 139, 73-83.

Cited by

  1. Adverse outcomes of long-term use of proton pump inhibitors vol.30, pp.12, 2018,