Endoscopic findings and diagnoses in unselected dyspeptic patients at a primary health care center.

This study reports the findings on endoscopy and the final diagnoses of 172 consecutive patients with dyspepsia from a primary health care center. The purpose of our study was to carry out a thorough gastroenterologic investigation of all patients consulting their general practitioner and reporting dyspepsia during 1 full year, from a population within a defined geographic area. The examinations included patient history, physical examination, laboratory tests, esophagogastroduodenoscopy (EGD), and sigmoidoscopy. All the examinations, including the EGDs, were done at the primary care center. A final diagnosis was settled after a minimum of 6 months. Six per cent had esophagitis, 13% had peptic ulcer disease, 1% had gastric cancer, and 1% had irritable bowel disease. Completely normal endoscopies were seen in 19%. No patient had villous atrophy. Sixty-four per cent had non-ulcer dyspepsia, and 26% had inflammatory bowel syndrome, with great overlapping. It is concluded that open-access endoscopy is a valuable service to primary care, the result of which greatly enhances the diagnostic accuracy in dyspeptic patients entering primary care.