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Upper Gastrointestinal Disease in Nairobi and Nakuru Counties, Kenya; A Two YearComparative Endoscopy Study

Makanga W 1, Nyaoncha A 2

  1. Surgery Department, St Mary’s Mission Hospitals

  2. Aga Khan University Hospital, Nairobi

Correspondence to: Dr. Winston Makanga. P.O Box 168-20116 Gilgil, Kenya. Email wmakanga@yahoo.com

Abstract

Introduction: Upper gastrointestinal (UGI) complaints are a common presentation in many outpatient clinics. St Mary’s Mission Hospitals run two endoscopy units in Nairobi and Nakuru. The pattern of upper GI disease around Nakuru has not been studied in region before. We audited the pattern of upper GI disease in patients undergoing upper GI endoscopy (UGIE) in both centres and assessed the scope of interventional endoscopic procedures. Methods: A two year retrospective study of all diagnostic and interventional UGIEs done at both units from December 2011 to August 2013. Results: A total of 6,110 (5,948 [97%] were diagnostic) patients underwent UGIE in both centres. The age range was 6- 92 (a mean of 44) years. The male to female ratio was 1:1.14. Of the diagnostic UGIEs, normal findings were found in 2,081 patients (35%). Gastritis was reported in 1,560 patients (26%), duodenal ulcer in 594 patients (10%), GERD/esophagitis in 137 patients (2%) and gastric ulcer in 312 patients (5%). Tumors composed of 507 cases (8.5%); esophageal tumors were 342, gastric tumors were 98 and gastroesophageal junction tumors were Significant differences in the two centers were in gastritis, hiatus hernia, esophageal varices, gastric ulcer and esophageal cancer. A total of 152 interventional UGIEs (86% palliative stenting) were done. Conclusion: The pattern of disease mirrors that in previous studies with a predominance of gastritis as the major upper gastrointestinal morbidity. Esophageal varices, benign gastric ulcers and esophageal tumors show a significant difference between the two centres.

 

Key Words: Endoscopy, Peptic, Ulcer, Dyspepsia

Introduction

Upper gastrointestinal complaints are a common presentation in many outpatient clinics. These complaints range from epigastric pain, bloating, heartburn (these three in various combinations are conventionally known as dyspepsia), vomiting, dysphagia, odynophagia and hematemesis. Endoscopy is key to diagnosis and in some cases, management of many of these conditions(1). Save for hepatobiliary disease, whose diagnosis mainly relies on ultrasound, most other upper gastrointestinal morbidity are diagnosed endoscopically. St. Mary’s Mission Hospitals in Nairobi and Nakuru run outpatient clinics