Background and objectives
The prevalence of clinically significant endoscopic findings in people with dyspepsia and understanding how symptoms can predict endoscopic pathology may help inform dyspepsia guidelines. We evaluated this in an updated systematic review and meta-analysis.
Methods
We searched MEDLINE, EMBASE, and Cochrane CENTRAL and the Cochrane Database of Systematic Reviews from 2010 to January 2022 to identify relevant articles. Eligible studies included adults from the community, workplace, screening or blood donation clinics, family doctor offices, or internal medicine clinics.
Studies were required to report prevalence of dyspepsia and perform esophagogastroduodenoscopy.
The prevalence of clinically significant endoscopic findings in subjects with and without dyspepsia was pooled for all studies and compared using odds ratios (OR) and 95% confidence intervals (CI). The data were pooled with those from the nine studies included in the previous review.
Results
Of 511 articles evaluated, 184 reported prevalence of dyspepsia. Fifteen reported the prevalence of endoscopic findings among 41,763 participants (40.4% with dyspepsia).
Erosive esophagitis was the most common abnormality (pooled prevalence, 11.0%; 95% CI, 8.9% to 13.2%), followed by peptic ulcer (pooled prevalence, 4.4%; 95% CI). , 2.5% to 6.7%.
The only finding found more frequently in people with dyspepsia compared to those without dyspepsia was peptic ulcer (OR 1.61, 95% CI 1.08-2.39).
More than 85% of esophagogastroduodenoscopy was completely normal.
Gastroesophageal cancer was rare (<0.4%) and equally prevalent among those with and without dyspepsia.
Conclusions
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