In contrast, some authors document a good predictive value of the alarm features in patients with dyspepsia when endoscopy is performed, and support the use of endoscopy in these patients. Other workers have documented a similar finding. In a systematic review and meta-analysis of 15 studies with 57,363 patients, the overall sensitivity and specificity of the alarm features in predicting GI malignancy on endoscopy were 0-83% and 40-98% respectively, while the sensitivity and specificity with just clinical diagnosis of upper GI malignancy by a physician were 11-53% and 97-98% respectively, leading the authors to conclude that the alarm features only have limited value for predicting underlying malignancy. Several studies have sought to determine the utility of alarm features in predicting serious upper GIT disease, with conflicting results. Various guidelines recommend that dyspeptic patients over 55 years, and those with alarm features (bleeding, anaemia, early satiety, unexplained weight loss, progressive dysphagia, odynophagia, persistent vomiting, family history of GIT cancer, previous oesophago-gastric malignancy, previous documented peptic ulcer, and lymphadenopathy) undergo prompt endoscopy to rule out peptic ulcer disease, oesophagogastric malignancy and other rare upper GIT disease. In a study in a rural community in north eastern Nigeria, a prevalence of 26% was documented. ![]() In a study of GIT outpatient consultations at the Lagos University Teaching Hospital (LUTH), patients with dyspepsia comprised 31.6% of the 1663 patients seen. Dyspeptic symptoms constitute a significant proportion of outpatient gastrointestinal (GIT) consultations. Dyspepsia is defined by the Rome criteria as chronic or recurrent pain or discomfort that is located in the upper abdomen, and includes symptoms such as early satiety, bloating, upper abdominal fullness or nausea.
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