Document Type : Research Paper

Author

Department of Medicine, College of Medicine, University of Ninevah, Mosul, Iraq

Abstract

Background: Dysphagia is an alarm gastrointestinal symptom that may be a manifestation of serious underlying condition, which necessitate proper and timely medical intervention. 
Objectives: To disclose the underlying conditions in patients presenting with dysphagia through endoscopic examination and assess associated alarm features.
Patients and Methods: This is a retrospective cross sectional study that was carried out in Al-Salam General Teaching Hospital in Mosul (Iraq) from January 2018 to January 2020. A total of145 patients (females 85, males 60) presenting with dysphagia were subjected to upper gastrointestinal endoscopic examination. Demographic characteristics, clinical features and detailed endoscopic findings were collected and analyzed.
Results: Mean age of patients was 48.4 (SD ± 17.5) years, age range 18-89 years, females constituted (85/145, 58.6%) and males (60/145, 41.4%). Endoscopic findings were esophagitis/ulcer associated with gastroesophageal reflux disease (GERD) (24.1%), neoplasms (15.2%), achalasia (6.9%), candida esophagitis (3.4%), drug-induced esophageal lesions (3.4%), hiatus hernia (2.8%), esophageal strictures (2.1%), and Schatzki ring (1.4%). Normal endoscopic findings were detected in 40.7% of patients.  Main symptoms associated with dysphagia were chest pain and heartburn (20.7%). Age groups > 50 years were affected in 85% of patients having malignancy, while weight loss and anemia affected 80% and 40% of such patients respectively.
Conclusion: Endoscopy detected significant esophageal lesions in about two thirds of patients presenting with dysphagia. Age above 50 years, weight loss and anemia, are predictive of malignancy, and endoscopy has a diagnostic role in this setting.

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