Issn Print: 0954-691X
Publication Date: 2006/01/01
Evaluation of endoscopy outcomes a decade after nationwide introduction of protonpump inhibitors and guidelines for Helicobacter pylori eradication
Excerpt
In several studies incidences of different gastrointestinal diseases have been investigated among patients referred for open access upper gastrointestinal endoscopy. However, since the nationwide introduction of proton pump inhibitors and guidelines for H. pylori eradication over a decade ago, it is expected that incidences of endoscopic findings have changed. Therefore, the aim of this study was to compare current prevalences of different gastrointestinal diseases with prevalences of these diseases 15 years ago. Data about endoscopy outcomes of consecutive patients referred to a primary care hospital for open access endoscopy between January 2002 and December 2004 was collected from medical files. This was compared with data from three populations with similar characteristics described by Adang et al. (Appropriateness of indications for diagnostic upper gastrointestinal endoscopy: association with relevant endoscopic disease. Gastrointest Endosc 1995; 42:390–397), Numans et al. (How useful is selection based on alarm symptoms in requesting gastroscopy? An evaluation of diagnostic determinants for gastro-oesophageal malignnancy. Scand J Gastroenterol 2001; 36:437–443), and Schaap et al. (Endoscopic studies of the digestive tract as a service for family practitioners; experience in the Eindhoven area. Ned Tijdschr Geneesk 1993; 137:1142–1146) over a decade ago. Weighted mean prevalences were calculated and outcomes were compared with our data using chi-square. Our current study population consisted of 1298 subjects: 49% was male and mean age (range) was 54(18–91). The total historical population included 3004 subject, with a mean age (range) of 50 (15–88) and 57% was male. The prevalences of peptic ulcer disease and duodenitis statistically significant decreased from 16.7% to 5.7%; P<0.01 and from 11.4% to 5.4%; P<0.01, respectively. The prevalence of oesophagitis statistically significant increased: from 15.4% to 21.9%; P<0.01, while gastroesophageal cancer is currently as frequent as it was in the historical population: 1.7% vs. 1.8%; P=0.87.
Conclusion The nationwide introduction of proton pump inhibitors and guidelines for H. pylori eradication has led to a decrease in prevalences of peptic ulcer disease and duodenitis. The increase of oesophagitis at endoscopy supports the hypothesis that H. pylori eradication might contribute to the development of oesophagitis.
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