The necessity of gastric mucosal biopsy in dyspeptic patients with normal upper endoscopy in Modarres hospital 2017-2018

Abstract

Background: Considering the diagnostic and therapeutic costs of patients with dyspepsia and the importance of diagnosis during gastrointestinal malignancies, in this study, we investigated the necessity of gastric mucosal biopsy in dyspeptic patients with normal upper endoscopy in Modarres hospital and their 6 months follow up. We studied their endoscopic biopsies changes and some of the involved risk factors this duration. Materials and Methods: In this clinical trial study, 115 patients with dyspepsia, were referred from gastroenterology clinic of Modarres hospital during 2017-2018, were evaluated. Patients were enrolled in a study that did not have any ulcer and mass or deep mucosal lesion in the early endoscopy Surface erosions were no exception and could be included. Five biopsy samples were obtained from different stomach sites. After the pathology results, the patients who had malignancy reports, excluded from the study and other patients were treated with anti-acid drugs and, if necessary, eradicated Helicobacter pylori. After 6 months, they were again subjected to endoscopy and biopsies were taken. Data were analyzed by SPSS software version 22. Results: The rate of Helicobacter pylori in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 20.9% vs 12.2%. The severity of chronic gastritis mild to moderate in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 89.6% vs 80%. There was a significant difference between metaplasia in patients with endoscopic dyspepsia without mucosal lesions before and 6 months after treatment p<0.05, 33%, vs 20%. Female gender, negative family history of GI cancer and not using alcohol were factors that significantly improved the results of biopsy chronic gastritis/ H. pylori /metaplasia after 6 months. Conclusion: Regarding the reduction in the severity of chronic gastritis, Helicobacter pylori and metaplasia in this group of patients after 6 months of treatment, it is recommended that refraining from unnecessary follow-up and biopsy and imposing cost to the patient and the medical system and be limited to high-risk groups.

Keywords

• dyspepsia, endoscopy, helicobacter pylori, chronic gastritis, metaplasia.