Prevalence of gastroesophageal reflux disease among patients with dyspepsia undergoing endoscopy in a tertiary hospital in Nigeria

Background: Dyspepsia is a symptom complex rather than a specific disease entity. It can be caused by various diseases that could be organic or functional dyspepsia. Gastro-esophageal reflux disease (GORD) now accounts for the majority of upper gastrointestinal symptoms. Clinical judgment alone is unsatisfactory and unreliable in confirming the etiology due to the overlap which exists between the clinical presentations of the disease conditions causing dyspepsia. This study aimed to determine the burden of GORD among patients with dyspepsia. Materials and Methods: The study was carried out between May and August 2009. A total of 170 dyspeptic patients were recruited consecutively as they were referred to the Gastroenterology Unit of Aminu Kano Teaching Hospital for upper gastrointestinal endoscopy. After obtaining a signed written informed consent from each patient a prepared questionnaire on relevant demographic, and clinical history relating to GORD was administered. Upper gastrointestinal endoscopy was then performed on each subject after an overnight fast of at least 8 h. GORD was defined as symptoms of heartburn and/or regurgitation lasting longer than 6 months with or without erosive esophagitis, Barrett's esophagus, esophageal peptic stricture, ulcer or adenocarcinoma on endoscopy. Results: The prevalence of GORD was found to be 24.1% among the dyspeptic patients in this study Endoscopy positive accounted for 16 (9.4%) while endoscopy negative accounted for 25 (14.7%) of GORD. Reflux symptoms were observed in 63 (37.1%) of the patients studied. Heartburn had a high specificity (92.3%) and negative predictive value (77.3%) with low sensitivity (14.6%) and positive predictive value (37.5%), while for regurgitation specificity was 91.6%, negative predictive value of 63.6%, sensitivity of 11.1% and positive predictive value of 43.8% for endoscopy positive GORD. Conclusion: Gastroesophageal reflux disease is a common disease for which patients are referred for upper gastrointestinal endoscopy.