Nwokediuko Sylvester Chuks, Ijoma Uchenna, Obienu Olive, Picardo Neri
Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu State, Nigeria.
Ann Gastroenterol. 2012;25(1):52-56.
The changing epidemiology of a disease often provides valuable insight into possible etiopathogenic mechanisms. There have been significant changes over the last several decades in disease manifestations of the foregut in Western Europe, North America and Asia. This time trend analysis was carried out to determine if any changes have occurred in the prevalence of diseases of the upper gastrointestinal tract in Nigeria.
Records of patients who underwent upper gastrointestinal endoscopy during two time periods (1995 to 1999 and 2006 to 2010) in Enugu, South-East Nigeria were analyzed with regard to biodata of patients, indications for upper gastrointestinal endoscopy and endoscopic findings.
During the two time periods, 1,365 patients had upper gastrointestinal endoscopy (575 patients in the period 1995-1999 and 790 in the period 2006-2010). Dyspepsia was the commonest indication for upper gastrointestinal endoscopy for both periods (81.9% and 72.9%, respectively; p= 0.9052). Heartburn and dysphagia were more frequent during the second time period (p<0.0001). Duodenal ulcer was more common in the first time period (p<0.0001), while esophagitis, gastric ulcer and bile reflux were significantly more common in the second period (p<0.0001, p=0.0007 and p=0.0019, respectively).
Over the 15-year period, the prevalence of duodenal ulcer has declined while that of gastric ulcer has increased. There has also been an increase in the prevalence of gastroesophageal reflux disease. Putative explanations for this trend may include widespread availability and use of very potent acid suppressant drugs, increasing use of non steroidal anti-inflammatory drugs, change towards western diet and increasing obesity.
疾病流行病学的变化往往能为潜在的病因发病机制提供有价值的见解。在过去几十年中，西欧、北美和亚洲前肠疾病的表现发生了显著变化。进行此次时间趋势分析，以确定尼日利亚上消化道疾病的患病率是否发生了任何变化。
分析了尼日利亚东南部埃努古两个时间段（1995年至1999年和2006年至2010年）接受上消化道内镜检查患者的记录，内容包括患者的生物数据、上消化道内镜检查的指征和内镜检查结果。
在这两个时间段内，共有1365例患者接受了上消化道内镜检查（1995 - 1999年期间有575例患者，2006 - 20年期间有790例患者）。消化不良是两个时间段上消化道内镜检查最常见的指征（分别为81.9%和72.9%；p = 0.9052）。烧心和吞咽困难在第二个时间段更为常见（p < 0.000）。十二指肠溃疡在第一个时间段更为常见（p < 0.0001），而食管炎、胃溃疡和胆汁反流在第二个时间段显著更为常见（分别为p < 0.0001、p = 0.0007和p = 0.0019）。
在这15年期间，十二指肠溃疡的患病率下降，而胃溃疡的患病率上升。胃食管反流病的患病率也有所增加。这种趋势的可能解释包括强效抑酸药物的广泛可得和使用、非甾体抗炎药使用的增加、饮食习惯向西方化的转变以及肥胖率的上升。
