Etiological profile of dyspepsia in difficult-to-reach tribal population of Himachal Pradesh

Abstract

Background: Dyspepsia exhibits a diverse range of underlying causes, with functional dyspepsia (FD) surpassing organic etiologies in prevalence. However, there exists a noticeable absence of prior research delineating the etiological spectrum of dyspepsia among the tribal regions of Himachal Pradesh (HP). The present study was carried out to determine the etiological profile of dyspepsia within this specific population. Materials and Methods: Conducted as a cross-sectional observational study centered around an endoscopy health camp, this investigation took place at the community health center in Kaza – a pivotal administrative hub in the remote Spiti Valley of the Lahaul and Spiti tribal district in HP. The study encompassed consecutive patients above 18 years of age presenting with gastrointestinal complaints. Those predominantly reporting dyspepsia were selected and subsequently underwent thorough endoscopic examination. Data analysis incorporated factors such as age, gender, history of smoking, alcohol consumption, nonsteroidal anti-inflammatory drug usage, and endoscopic findings. Results: Encompassing a total of 187 patients with an average age of 48.5 ± 13.4, the study found that endoscopy yielded normal results in 59.9% of cases (categorized as FD), whereas 40.1% displayed abnormal findings (categorized as organic dyspepsia). Among the latter, the most prevalent organic lesions were peptic ulcer disease (PUD) (62.7%) and erosive esophagitis (22.7%). Furthermore, gastric malignancy was detected in 4% of the cases. Conclusion: The primary organic causes of dyspepsia within the tribal areas of HP appear to be dominated by PUDs, closely followed by erosive esophagitis. Gastric malignancy, although less frequent, was identified in approximately 4% of the dyspeptic cases studied.

Keywords

• dyspepsia
• erosive esophagitis
• functional dyspepsia
• gastric cancer
• organic dyspepsia
• peptic ulcer disease