SEARCH · Search PubMed

Results for “ENDOSCOPY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,441 records · Page 80Linked to original sources

PubMed2002

Endoscopy in patients receiving radiation therapy to the thorax.

Radiation therapy for thoracic malignancies is often complicated by radiation-induced esophagitis. Symptoms of radiation esophagitis are nonspecific and include dysphagia, odynophagia, and chest pain. Patients receiving radiation therapy are also at risk for infectious esophagitis, which can be indistinguished clinically from radiation-induced esophagitis. We retrospectively reviewed data on patients who had esophagitis symptoms during or after thoracic radiation therapy and were referred for upper endoscopy. We sought to determine how often infectious esophagitis or cancer was present, as compared to radiation-induced esophagitis alone. Twenty-four upper endoscopies were performed on 16 patients over a three-year period to evaluate esophagitis symptoms. Forty-four percent of the patients endoscoped had infectious esophagitis or recurrent cancer diagnosed by endoscopy. No complications occurred from the procedures. Esophagoscopy is a safe procedure that should be considered, to exclude infection or cancer, in patients who develop esophagitis symptoms during or after thoracic radiation.

Diagnosis, Differential↗

PubMed2006

[Nutrition, probiotics, antibiotics, antioxidative therapy, endoscopy in chronic pancreatitis].

Treatment of chronic pancreatitis is dependent on the stage of the disease and consists of several arms: treatment of pain when ever possible according to its pathogenesis; treatment of complications primarily by interventional endoscopy, in cases of failure by surgery; therapy of exocrine insufficiency with porcine pancreatic extracts; treatment of endocrine insufficiency with insulin. Pseudocysts can be drained according to their location by either the transgastric, transduodenal, transpapillary or transcutaneous route. Distal prepapillary stenoses of the main pancreatic duct can be handled by placement of a plastic stent; similarily to treatment of biliary strictures. Stones leading to obstruction of the main pancreatic duct can be disintegrated by extracorporeal shock wave lithotripsy (ESWL) and the fragments removed by endoscopy after papillotomy. Transgastral endoscopic drainage of retroperitoneal necroses is still experimental. Prospective randomized multicenter trials comparing surgery with interventional endoscopy are still lacking. Failure of endoscopic therapy or suspicion of tumor is clearly an indication for surgery. There is no need for a specific diet in patients with chronic pancreatitis without having diabetes. In severe attacks, clinically similar to acute pancreatitis, enteral nutrition via a jejunal tube is replacing parenteral nutrition. However, prospective comparative trials are still mandatory. Prophylactic application of antibiotics in patients with pancreatic necrosis is again under debate. Whether probiotics are capable to decrease the risk of secondary pancreatic infection of necrosis has not been thoroughly studied. The hypothesis that capture of oxygen free radicals by drugs such as selenium may prevent frequency and severity of acute relapses has also not been proven.

Anti-Bacterial Agents↗

PubMed2003

Symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain.

AIM: To determine whether symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy-negative patients with non-cardiac chest pain. METHODS: Patients who complained of chest pain, but had normal coronary angiography, were asked to undergo upper endoscopy. Those without gastric and oesophageal lesions were recruited for 24-h ambulatory oesophageal pH monitoring, and were randomly given lansoprazole 30 mg or placebo, both daily for 4 weeks. Chest pain symptoms were recorded before and 1 month after treatment on a locally validated questionnaire. The symptom score was calculated by multiplying the severity and frequency of the symptom, and symptom improvement was defined as > 50% reduction in symptom score. RESULTS: Overall, 68 patients, 36 on lansoprazole and 32 on placebo, completed the trial. The symptom score was reduced significantly in both groups (P < 0.001). In the lansoprazole group, more patients with than without abnormal reflux showed symptom improvement (92% vs. 33%; odds ratio = 22; 95% confidence interval, 2.3-201.8; chi2 = 10.9; P = 0.001), giving a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 92%, 67%, 58%, 94% and 75%, respectively. In the placebo group, the rates of symptom improvement were similar between those with and without abnormal reflux (33% vs. 35%, P = N.S.). CONCLUSIONS: Treatment with lansoprazole is a useful test in diagnosing endoscopy-negative gastro-oesophageal reflux disease in Chinese patients with non-cardiac chest pain.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2003

Use of intramuscular ketamine for endoscopy sedation in children.

OBJECTIVE: To report the experience of the use of intramuscular (IM) ketamine for endoscopy sedation in children. METHODOLOGY: Children over 6 months of age scheduled for elective endoscopy - esophagogastroduodenoscopy (EGD), bronchoscopy and nasopharyngolaryngoscopy (NPL) were enrolled for (2 mg/kg to 3 mg/kg) intramuscular ketamine sedation. A repeated dose of 2 mg/kg intramuscular ketamine was administered to those who failed the first sedation. Alternative sedation (intravenous midazolam and fentanyl) was given to children who failed ketamine sedation twice. Sedation was regarded as successful if the procedure was completed by endoscopist with a single dose of ketamine. RESULTS: Sixty children were enrolled for the study. Overall success rate in our patients was 78.3%. Failure rate in infants was 50%, i.e. 4 out of 8. For children aged 1-7, the failure rate was 32%. Failure rate dropped markedly to 6.7% for those older than 7 years of age, and it showed significant difference when compared with the other two groups. Two cases of laryngospasm were experienced in the present study. CONCLUSION: Intramuscular ketamine is an effective medication for sedation in endoscopy undertaken in children over age 7 years, but it should be avoided with children under age 7 because of the high failure rate.

Adolescent↗

PubMed2000

Endoscopy-negative reflux disease.

The majority of patients with symptoms of gastro-oesophageal reflux have no endoscopic evidence of oesophagitis. There has been remarkably little systematic gathering of information about this group of patients. It is commonly believed that they have a mild form of reflux disease, with low levels of dysfunction that usually respond to simple therapeutic measures. Emerging data from recent studies indicate that this is not the case. Endoscopy-negative patients have symptom severities comparable to those with erosive disease, and which significantly impair their quality of life. The limited data available on the pathophysiology of endoscopy-negative reflux disease suggest that, in the majority of patients, it is as much a disease of excessive gastro-oesophageal reflux as it is in patients with oesophageal lesions. The same principles that apply to successful treatment in patients with oesophagitis also hold true for patients with endoscopy-negative disease.

Anti-Ulcer Agents↗

PubMed2004

Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo.

BACKGROUND & AIMS: A confocal laser endoscopy system has recently been developed that may allow subsurface imaging of living cells in colonic tissue in vivo. The aim of the present study was to assess its potential for prediction of histology during screening colonoscopy for colorectal cancer. METHODS: Twenty-seven patients underwent colonoscopy with the confocal endoscope using acriflavine hydrochloride or fluorescein sodium with blue laser illumination. Furthermore, 42 patients underwent colonoscopy with this system using fluorescein sodium. Standardized locations and circumscript lesions were examined by confocal imaging before taking biopsy specimens. Confocal images were graded according to cellular and vascular changes and correlated with conventional histology in a prospective and blinded fashion. RESULTS: Acriflavine hydrochloride and fluorescein sodium both yielded high-quality images. Whereas acriflavine hydrochloride strongly labeled the superficial epithelial cells, fluorescein sodium offered deeper imaging into the lamina propria. Fluorescein sodium was thus used for the prospective component of the study in which 13,020 confocal images from 390 different locations were compared with histologic data from 1038 biopsy specimens. Subsurface analysis during confocal laser endoscopy allowed detailed analysis of cellular structures. The presence of neoplastic changes could be predicted with high accuracy (sensitivity, 97.4%; specificity, 99.4%; accuracy, 99.2%). CONCLUSIONS: Confocal laser endoscopy is a novel diagnostic tool to analyze living cells during colonoscopy, thereby enabling virtual histology of neoplastic changes with high accuracy. These newly discovered diagnostic possibilities may be of crucial importance in clinical practice and lead to an optimized rapid diagnosis of neoplastic changes during ongoing colonoscopy.

Acriflavine↗

PubMedDate not supplied

Podotrochlear bursa endoscopy in the horse: a cadaver study.

OBJECTIVES: To evaluate podotrochlear bursa (navicular bursa) endoscopy as a diagnostic technique in horses and to correlate observations to radiographic and pathologic findings. STUDY DESIGN: Descriptive study. SAMPLE POPULATION: Seventeen equine cadaver forelimbs. METHODS: Five standard radiographic views of the navicular region and a bursographic study with lateromedial and caudal tangential radiographic views were taken of each forelimb. Radiographic scoring of the navicular bone (0, excellent; 1, good; 2, fair; 3, poor) was performed using a previously reported technique. Endoscopic examination was performed using a 30 degrees wide-angle forward oblique-viewing, 4-mm outside diameter (OD), arthroscope. Four examiners using recorded videotapes made independent evaluations of bursal endoscopy. The specimens were then dissected and examined to verify radiographic and endoscopic findings. RESULTS: The distribution of radiographic scores (RS) were 0 (5 limbs), 1 (7), 2 (2), and 3 (3). Abnormal endoscopic findings (fibrillation of the deep digital flexor tendon, a defect in the navicular bone fibrocartilage, and synovial hyperplasia) were identified in 3 limbs (2 with an RS of 1, and 1 with an RS of 3). The endoscopic observations made in the two RS 1 bursae were not confirmed on gross examination, whereas they were in the RS 3 specimen, which also had the only abnormal bursogram. Evaluation of the bursa on the side ipsilateral to the arthroscope portal was difficult. Complications of the technique included inadvertent penetration of the distal interphalangeal joint and the digital sheath, and superficial scoring of the navicular bone fibrocartilage. CONCLUSIONS: Podotrochlear bursa endoscopy is feasible and may be a useful technique in identifying early abnormalities associated with podotrochleosis. CLINICAL RELEVANCE: In horses with podotrochleosis, endoscopic examination of the podotrochlear bursa may improve identification of pathologic changes within the bursa.

Animals↗

PubMed1976

Disinfection procedures of fiberscopes in endoscopy departments.

Disinfection of fibre endoscopes was examined in 5 endoscopy departments during endoscopy sessions. On the endoscopes, especially in the instrument channels, Pseudomonas aeruginosa and Proteus species could be regularly found, in some cases also Enterobacter cloacae and Candida albicans. With the results of disinfection experiments, proposals are made to reduce the infection risk due to insufficiently disinfected instruments in endoscopy departments.

Bacteriological Techniques↗

PubMed2005

Objective benefit of a 1-day training course in endoscopic hemostasis using the "compactEASIE" endoscopy simulator.

BACKGROUND AND STUDY AIMS: The Erlangen Active Simulator for Interventional Endoscopy (EASIE) was introduced in 1997 as a training model for interventional endoscopy. Objective evidence of the benefits of training with this model has not previously been published. As part of two long-term projects, the benefits of a 1-day training course with the "compactEASIE" simulator were evaluated. MATERIALS AND METHODS: Fourteen American and 18 French gastroenterology fellows were enrolled. These fellows were participants in the intensive groups performing training in endoscopic hemostasis, with a total number of 28 fellows in New York and 36 in France. Gastrointestinal endoscopy faculty members in New York and France evaluated and timed the fellows in four disciplines to establish baseline skills (manual skills; injection and coagulation; Hemoclip application; and variceal ligation) with the compactEASIE simulator. The trainees were reevaluated after an intensive 1-day course (with two or three fellows and one instructor per station), also including preparation and assistance for each procedure. The assessment (overall and parts) was done by expert tutors using an ordinal scale ranging from 1 to 10 (1 = poorest, 10 = best), recording also mistakes and performance time. The compactEASIE simulator, equipped with an upper gastrointestinal organ package and an artificial blood perfusion system, was used as the training tool. RESULTS: A highly significant improvement ( P < or = 0.001) was observed in the performance of all endoscopic techniques. A significant reduction in performance time was also observed with three of the four endoscopic techniques. Successful hemostasis was significantly improved in two out of three techniques. CONCLUSIONS: A 1-day training course on endoscopic hemostasis using the compactEASIE simulator is capable of improving the performance of hemostasis procedures. Long-term effects of repeated training sessions are currently subject of collaborative studies in New York and France.

Clinical Competence↗

PubMed2005

Magnifying endoscopy in gastritis of the corpus.

Endoscopic diagnosis of Helicobacter pylori infection, before biopsies and serological tests are performed, is possible through careful analysis of the network of superficial vessels in patients with gastritis. At standard endoscopy, a regular arrangement of the collecting venules (RAC) is visible as numerous minute red points in the corpus of the noninfected stomach, and is not visible in H. pylori gastritis. Magnifying endoscopy provides more precise information concerning the collecting venules, the network of capillaries surrounding the gastric pits, the swelling of the surface epithelium between pits, and the enlargement and destruction of the pits. The magnified appearance is classified as Z-0 (noninfected stomach) or as Z-1 to Z-3 for successive degrees of mucosal damage in the infected stomach. Histological controls confirm the reliability of the endoscopic classification. Magnifying endoscopy also proves helpful in the assessment of completeness of eradication of H. pylori.

Gastric Mucosa↗

PubMed2006

A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy.

BACKGROUND AND STUDY AIMS: With endoscopy, there is a high rate of interobserver variability in the identification of gastric intestinal metaplasia, and the endoscopic findings correlate poorly with the histological findings. Previous studies by our group investigating the use of a narrow-band imaging system with magnifying endoscopy (NBI-ME) in the gastric mucosa suggested that the appearance of a light blue crest (LBC) on the epithelial surface may be a distinctive endoscopic finding associated with the presence of intestinal metaplasia. The aim of the present study was to clarify the value of NBI-ME for diagnosing gastric intestinal metaplasia. PATIENTS AND METHODS: The LBC was defined as a fine, blue-white line on the crests of the epithelial surface/gyri. To investigate the histology underlying the appearance of LBC, 44 biopsy specimens were obtained from regions containing LBC and 44 from non-LBC mucosa in 34 patients with atrophic gastritis. Three endoscopists then carried out NBI-ME in 107 consecutive patients to validate the diagnostic accuracy of the novel endoscopic technique. The degree of correlation between the LBC grading and the histological parameters of intestinal metaplasia was then assessed. RESULTS: The LBC grading correlated with cells that were positive for CD10 ( P = 0.0001) and Alcian blue ( P = 0.036). The appearance of LBC correlated with histological evidence of intestinal metaplasia with a sensitivity of 89 % (95 % CI, 83 - 96 %), a specificity of 93 % (95 % CI, 88 - 97 %), a positive predictive value of 91 % (95 % CI, 85 - 96 %), a negative predictive value of 92 % (95 % CI, 87 - 97 %), and an accuracy of 91 % (95 % CI, 88 - 95 %). CONCLUSIONS: In narrow-band imaging with magnifying endoscopy, observation of a light blue crest on the epithelial surface in the gastric mucosa is a highly accurate sign of the presence of histological intestinal metaplasia.

Adult↗

PubMed1995

A prospective, controlled trial of eight-bit, 16-bit, and 24-bit digital color images in electronic endoscopy.

BACKGROUND AND STUDY AIMS: Digital color information is obtained in "bits" or parcels of information for each color (red, green, blue) of a picture. As the number of bits increases, the amount of color information increases, and more colors can be displayed on a suitable monitor. With eight bits of information, 256 colors can be displayed; with 16 bits, several thousand colors can be displayed; and with 24 bits, more than 16 million colors can be displayed. We sought to determine the minimum requirement for diagnostic-quality endoscopy images in a prospective blinded trial. PATIENTS AND METHODS: Twenty-four bit color images were digitally acquired from the processor using a video card and a personal computer. Ten lesions were chosen to represent the gamut of lesions seen in the upper gastrointestinal tract. Images were simultaneously obtained with decreasing color information (16 and eight bits), and these served as controls. Eleven observers were the test subjects. Six endoscopy nurses, who perform color calibrations, and five endoscopists viewed the images. Eight-bit, 16-bit and 24-bit color images were coded and displayed simultaneously on a high-resolution color monitor (Supermac Technology, Sunnyvale, CA) that can display 16.8 million colors. RESULTS: All images were considered to be of diagnostic quality by the observers, and the area of abnormality was identified and the diagnosis made in all cases. Of 110 viewings of the 24-bit image, on 45 occasions (41%) the viewers could detect no difference between it and the eight-bit and 16-bit images. In 23 (21%), the 24-bit color image was correctly recognized, and on 21 occasions (19%) the 24-bit image was incorrectly identified as eight-bit or 16-bit. Similar data were obtained with viewings of the eight-bit and 16-bit images. CONCLUSIONS: Our results demonstrate that, with current endoscopic technology, 256 colors may be as good as 16 million. Eight-bit color is an acceptable image standard for routine endoscopy.

Endoscopes↗

PubMed1994

Conscious sedation, clinically relevant complications and monitoring of endoscopy: results of a nationwide survey in Switzerland.

There is no conclusive evidence that electronic monitoring during gastrointestinal endoscopy reduces patient morbidity and mortality. The aim of this nationwide Swiss survey was to assess the impact of monitoring on the outcome for patients. We therefore evaluated the monitoring practice and the rate of sedation-related clinically relevant complications in a country with a low monitoring prevalence, and compared the results with those for a country in which monitoring is widely applied. A questionnaire pertaining to 1990 was mailed to all 173 Swiss gastroenterologists. The response rate was 71.1%. Data from 115,200 endoscopies performed by 123 gastroenterologists were analysed. Sixty percent of the procedures were performed under sedation. Patient's vital signs were rarely monitored clinically (< or = 25%). Electronic monitoring was virtually never performed: oximetry was used by 2.5% and an electrocardiogram by 0.8%. The overall sedation-related complication rate was 0.10%, and no deaths occurred. Thus, the morbidity and mortality related to conscious sedation in Switzerland is low, and not higher than it is in countries with a high monitoring level, such as the USA (0.06-0.54%). We conclude that clinically detectable and relevant complications attributable to conscious sedation are rare even when vital parameters are not monitored routinely. There is need for a prospective study to evaluate the effect of electronic monitoring on the complication rate for average-risk patients undergoing routine gastrointestinal endoscopy.

Colonoscopy↗

PubMed1994

Identification and diameter assessment of gastric submucosal vessels using infrared electronic endoscopy.

In this study, an electronic endoscope was applied for observation of gastric submucosal vessels, with infrared illumination, in anesthetized dogs. An in-vivo spectrophotometry showed that infrared light at 620-820 nm penetrates the abdominal and gastric wall. During the endoscopy performed in dogs, the infrared radiation penetrated the abdominal wall and gastric wall from the outside, and was detected by the endoscope's charge-coupled device. A television monitor displayed a network of gastric vasculature, which was identified as veins in the gastric wall by injecting saline or indocyanine green into the vein. Using this system, it was possible to measure venous diameters of more than 0.2 mm by comparison with a reference wire. The diameter obtained by the image analysis correlated lineally to that of a vascular template prepared from the same stomach. Thus, it may become possible to assess gastric submucosal hemodynamics using infrared endoscopy, a new application in electronic endoscopy.

Abdominal Muscles↗

PubMed1996

[Three-dimensional surface imaging of the larynx and trachea by spiral CT: virtual endoscopy].

A survey presents the technical conditions and facilities of the computed tomographic virtual endoscopy. The inner surface of the upper airway was reconstructed from the data set of a helical CT. The anatomical structures were visualized in over 80 patients. 15 patients with a suspected tracheal stenosis were additional investigated. The virtual endoscopy allowed an identification of the anatomical structures. Pathological endoluminal findings, as stenosis, were investigated successfully. The virtual endoscopy combines the advantages of helical CT and the imaging of the endoluminal surface. Compared with the endoscopic examination the non-invasive technique offers additional indications, especially in high-risk patients or non-passable Stenosis.

Adult↗

PubMed1980

Crohn's disease of the stomach and duodenum: A clinical study with emphasis on the value of endoscopy and endoscopic biopsies.

The aim of this study was to correlate endoscopic, radiological and pathological observations in 30 patients with Crohn's disease, with involvement of the stomach and/or duodenum. The incidence of gastroduodenal involvement in our patients with Crohn's disease is about 3%. 22 of the 30 patients had intrinsic lesions of the stomach and/or duodenum; in 8 patients the lesions seemed to be produced by involvement from contiguous diseased bowel. Radiological studies and endoscopy of the gastroduodenal region are complementary. Endoscopy allows better visualisation of mucosal defects. Other features, for example a diminished expansion and the presence of contiguity lesions, are better demonstrated by barium meal. The mucosal lesions found at endoscopy are heterogenous, but irregularly-shaped ulcers and erosions in a disrupted mucosal pattern are typical for gastroduodenal Crohn's disease. Pathological examination of endoscopic "forceps"-biopsies permitted a conclusive diagnosis based on the presence of granulomas, in 15/22 (68%) of the cases with intrinsic gastroduodenal disease. This observation indicates that simple forceps biopsy is a very useful diagnostic tool. Involvement of the first part of the duodenum in Crohn's disease was complicated by a biliary fistula in two patients.

Adolescent↗

PubMed1981

[Emergency endoscopy of the upper gastrointestinal tract and therapeutic endoscopic procedures in childhood (author's transl)].

In the Department of Surgery, Bonn University Medical School, from 1.2.1977 - 1.8.1979 68 emergency endoscopies in children were performed. Up to the age of ten this was done with and over ten years without anaesthesia. The most frequent sources of bleeding in the specific groups were varices of the oesophagus and stomach. Further frequent sources of bleeding were duodenal ulcers, a Mallory-Weiss-syndrome, reflux-oesophagitis with hiatal hernia, erosions and polyps of the stomach and corrosive oesophagitis. The source of haemorrhage was found in 70%; a probable cause of bleeding was detected in 15%, in 6% no pathologic lesion was seen. In 42 children an operative endoscopy was used simultaneously: 41 times by a sclerosing procedure of the oesophageal wall, once in a bleeding polyp. Complications of the sclerotherapy were one case each of an incomplete wall necrosis of the oesophagus, a stenosis and a new bleeding from oesophageal varices. No child died. -The emergency endoscopy is able to improve the diagnosis of upper gastrointestinal bleeding. The decision for conservative or operative treatment can be made earlier and the results are more certain. The sclerotherapy of the oesophageal varices succeeded in stopping haemorrhage and preventing it in the future.

Adolescent↗

PubMed2003

Impact of clinical symptoms and referral volume on endoscopy for detecting peptic ulcer and gastric neoplasms.

BACKGROUND: We investigated the volume of dyspeptic patients referred by general practitioners (GPs) to upper gastrointestinal endoscopy and the impact on endoscopic findings. We also examined the correlation between clinical symptoms and endoscopic findings. METHODS: We collected data on patients sent for upper gastrointestinal endoscopy by GPs of 30 healthcare centres in 1996 in our hospital referral area of 260,000 inhabitants. In addition, national and local cancer registries were used to enumerate the gastric cancer cases detected in 1996. RESULTS: The study population consisted of 3378 patients, mean age 58 years (interquartile range 25 years, male:female 1:1.3). Among the 30 healthcare centres, referral volumes for upper gastrointestinal endoscopy varied from 0.6 to 9.2 per 1000 inhabitants per year (median 3.3/1000/year). In healthcare units with 'high' (> or = 3.3/1000/year, 15 healthcare units, 1297 patients) and 'low' (<3.3/1000/year, 15 healthcare units, 2065 patients) referral volumes, the detection rates were as follows: duodenal ulcer (DU) 3.5% (n = 46) versus 4.0% (n = 83, P = 0.5), gastric ulcer (GU) 4.9% (n = 64) versus 5.3% (n = 110, P = 0.6), gastropathy 43.8% (n = 568) versus 35.6% (n = 736, P < 0.001), gastric cancer 0.5% (n = 6) versus 0.5% (n = 11, P = 0.8), gastric polyps 2.4% (n = 31) versus 1.5% (n = 30, P < 0.05). Independent risk factors for gastric cancer were age (OR 6.5 per decade, 95% CI 2.4-17.9), male sex (OR 5.5, 95% CI 1.8-17.1) and alarming symptoms and/or signs (OR 3.6, 95% CI 1.2-10.7); for GU, Helicobacter pylori (OR 2.6, 95% CI 1.9-3.5) and alarming symptoms (OR 2.0, 95% CI 1.4-2.7); for DU, male sex (OR 1.6, 95% CI 1.1-2.2) and H. pylori (OR 3.9, 95% CI 2.7-5.5); and for gastric polyp(s), age (OR 2.0 per decade, 95% CI 1.1-3.5) and high referral volume (OR 1.7, 95% CI 1.0-2.0). A high referral volume did not associate positively either with the number of peptic ulcers or gastric cancer. CONCLUSIONS: Alarm symptoms associate strongly with significant gastric lesions such as GU and cancer. Increased referral volume results in an increased number of gastropathy and gastric polyp(s), but not of peptic ulcer or cancer.

Dyspepsia↗