Upper gastrointestinal endoscopy for dyspepsia and massive upper gastrointestinal haemorrhage

Abstract

We have retrospectively studied the causes of dyspepsia, and of haematemesis and melaena in patients investigated by flexible endoscopy by the Medical Gastroenterology Unit in Malta during 1986. Of 453 patients with dyspepsia, 30% had gastro-oesophageal reflux, 29% had acid peptic disease, 3% had gastric carcinoma and 26% had an entirely normal gastroscopy. The peak age distribution of these four groups were respectively 20-59 years, 40-59 years, 60-69 years, and 20-39 years. The chief causes of haematemesis and melaena were acid peptic disease, gastric erosions, oesophageal varices and gastric malignancy; the cause of bleeding was detected by endoscopy in 93% of cases. These data provide the basis for developing strategies for prospective studies, and the treatment of dyspepsia in Maltese patients. They also reinforce the extreme utility of endoscopy as a first line investigation for these common clinical problems.