Endoscopic and histologic findings in patients referred for endoscopy by general practitioners in 2008-2013

Introduction. Patients with gastroesophageal reflux disease who did not improve with proton pomp inhibitors are at risk of serious diseases and should undergo endoscopy. Aim. The aim of the study was to present endoscopic and histopathologic findings in the esophagus in patients referred by a general practitioners to the Department of Gastrointestinal and General Surgery, Wroclaw Medical University in years 2008-2013 with initial diagnosis of GERD, in which the family doctor did not achieve the expected results of the empirical treatment with proton pump inhibitors. Material and methods. The clinical material included 122 patients (51 women and 71 men) aged 55.8 ± 14.1 referred for endoscopy by their general practitioners because of a lack of improvement after empirical treatment. Retrospective analysis of the endoscopic and histologic finding was performed. Results. The most prevalent diagnosis was hernia hiatus oesophagi (n = 41; 33.6%) and the least Barrett’s esophagus (n = 6; 4.9%). In men the most prevalent diagnosis was adenocarcinoma (n = 22; 31.0%) and in women hiatal hernia (n = 24; 47.1%). Near 60% patients were found to have histopathologic abnormalities. The most common finding was oesophageal cancer (n = 22; 18.0%) and the least dysplasia (n = 7; 5.7%). In men the most prevalent diagnosis was adenocarcinoma (n = 21; 29.6%) and in women esophagitis (n = 8; 11.3%) and Barrett’s esophagus (n = 8; 11.3%). Conclusions. 1. Near one quarter of patients with ineffective GERD symptoms treatment, who were referred for endoscopy by family practitioners, has serious endoscopic and histologic diagnosis. 2. Male gender and age above 52 years are risk factors for esophageal adenocarcinoma. 3. GERD complications are more common in men and benign complications prevail among women.