Oung Borathchakra, Chea Khang, Oung Chakravuth, Saurin Jean-Christophe, Ko Cynthia W
Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital Hospices civils de Lyon Lyon France.
CHAKRA GI Clinic Phnom Penh Cambodia.
JGH Open. 2019 Jun 24;4(1):61-68. doi: 10.1002/jgh3.12210. eCollection 2020 Feb.
The diagnostic evaluation and management of patients with chronic dyspepsia may differ geographically according to patient age, prevalence of or parasitic infection, and risk of gastric cancer. The characteristics and appropriate investigation of Cambodian patients with dyspepsia have not previously been studied. The aim of this study was to investigate the characteristics of Cambodian patients with chronic dyspepsia, the yield of upper endoscopy in these patients, and the value of alarm features in identifying patients with organic causes of dyspepsia.
We conducted a retrospective, single-center study of 1231 adults with chronic dyspepsia who underwent upper endoscopy. We compared clinical characteristics, prevalence, and endoscopic and histological findings of patients with functional or organic causes of dyspepsia. This study was approved by the National Ethics Committee for Health Research.
The majority of patients had overlapping symptoms of epigastric pain/burning and postprandial fullness/early satiety (40.6%), followed by epigastric pain/burning alone (29.7%) and postprandial fullness/early satiety alone (29.7%). Organic lesions were diagnosed in 6.9% of patients. The overall prevalence of infection was 46% and was similar in the three clinical subgroups. The sensitivity and specificity of alarm features for organic causes of dyspepsia were 14 and 96%, respectively. The majority of patients with gastric cancer were 40 years of age or older.
The majority of patients with chronic dyspepsia seen at our outpatient center were diagnosed with functional or -associated dyspepsia. The presence of alarm features was not sensitive or specific for differentiating organic and functional dyspepsia.
慢性消化不良患者的诊断评估和管理可能因地域不同而有所差异，这取决于患者年龄、幽门螺杆菌感染率或寄生虫感染情况以及胃癌风险。此前尚未对柬埔寨消化不良患者的特征及适当检查进行研究。本研究旨在调查柬埔寨慢性消化不良患者的特征、这些患者上消化道内镜检查的诊断率，以及警示特征在识别有器质性消化不良病因患者中的价值。
我们对1231例接受上消化道内镜检查的慢性消化不良成年患者进行了一项回顾性单中心研究。我们比较了功能性或器质性消化不良病因患者的临床特征、幽门螺杆菌感染率以及内镜和组织学检查结果。本研究获得了国家卫生研究伦理委员会的批准。
大多数患者有上腹部疼痛/烧灼感与餐后饱胀/早饱的重叠症状（40.6%），其次是单独的上腹部疼痛/烧灼感（29.7%）和单独的餐后饱胀/早饱（29.7%）。6.9%的患者被诊断为器质性病变。幽门螺杆菌感染的总体发生率为46%，在三个临床亚组中相似。消化不良器质性病因警示特征的敏感性和特异性分别为14%和96%。大多数胃癌患者年龄在40岁及以上。
在我们门诊中心就诊的大多数慢性消化不良患者被诊断为功能性或幽门螺杆菌相关的消化不良。警示特征对于区分器质性和功能性消化不良既不敏感也不特异。
