Prevalence of lesions detected at upper endoscopy: An Italian survey

• Published in: European journal of internal medicine Vol. 25; no. 8; pp. 772 - 776
• Main Authors: Zullo, Angelo, Esposito, Gianluca, Ridola, Lorenzo, Hassan, Cesare, Lahner, Edith, Perri, Francesco, Bianco, Maria Antonietta, De Francesco, Vincenzo, Buscarini, Elisabetta, Di Giulio, Emilio, Annibale, Bruno
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2014
• Subjects: Adult; Duodenal Ulcer - epidemiology; Endoscopy, Gastrointestinal; Erosions; Female; Gastrointestinal Diseases - epidemiology; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Internal Medicine; Italy - epidemiology; Male; Middle Aged; Multivariate Analysis; Peptic ulcer; Polyp; Prevalence; Proton pump inhibitor therapy; Stomach Ulcer - epidemiology; Upper endoscopy; Italy; Upper endoscopy; Peptic ulcer; Proton pump inhibitor therapy; Erosions; Polyp
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2014.08.010

Abstract Background Prevalence of gastroduodenal lesions is changing in the last decades. Prevalence of Helicobacter pylori infection, non-steroidal anti-inflammatory drugs (NSAIDs), and proton pump inhibitor (PPI) therapy may be involved in such a phenomenon. We assessed gastroduodenal lesions prevalence in a nationwide study. Materials and methods Consecutive patients who underwent upper endoscopy for the first time in 24 Italian centres between January 2012 and 31 March 2012 were enrolled. Prevalence of gastric ulcer (GU), duodenal ulcer (DU), gastric erosions (GE), duodenal erosions (DE), gastric polyp (GP), Barrett's oesophagus (BE), and neoplasia was assessed. Results Overall, 1054 (M/F: 388/666; Mean age: 57.5 ± 5 years) patients were enrolled. H. pylori infection was detected in 356 (33.9%) patients, 358 (34%) were taking NSAIDs, and 532 (50.5%) PPIs. PPI therapy was associated with a significantly lower H. pylori detection rate (27.8% vs 39.8%; OR: 0.6, 95% CI 0.45–0.77; P < 0.001). GU, DU, GE, DE, GP and BE were detected in 17 (1.6%), 13 (1.2%), 150 (14.2%), 50 (4.7%), 51 (4.8%) and 17 (1.6%), respectively. Moreover, 3 (0.3%) distal gastric cancers were observed. H. pylori infection remained the most prevalent factor for all gastroduodenal lesions, but gastric polyp. One third of patients with GU and GE were taking only NSAIDs therapy. Conclusions The prevalence of peptic ulcer was very low (< 3%), with a similar rate between DU and GU. As many as half patients were on ongoing PPI therapy. Such a therapy could affect both the detection rate of H. pylori infection and the real prevalence of gastroduodenal lesions.