Prevalence of gastroduodenal lesions in chronic nonsteroidal anti-inflammatory drug users presenting with dyspepsia at the Kenyatta National Hospital

Citation:
Oyoo.G.O, Wanjohi.W, H.M K, Ogutu.E, Radia.K, Mutei.T.M. "Prevalence of gastroduodenal lesions in chronic nonsteroidal anti-inflammatory drug users presenting with dyspepsia at the Kenyatta National Hospital.". In: ISSN.; 2014.

Abstract:

Non-Steroidal Anti-
Inflammatory Drugs (NSAIDs) are
among the most widely prescribed and
used classes of drugs worldwide. They
are known to cause gastroduodenal
mucosal damage and can result in
ulcerations, upper gastrointestinal
bleeding, perforation and even death.
However, no local data exist to show the
prevalence.
Objectives: The main objective
was to determine the prevalence
of gastroduodenal lesions seen at
endoscopy and histopathology in
chronic NSAID users presenting with
dyspepsia at the Kenyatta National
Hospital.
Design: This was a hospital-based crosssectional
study.
Methods: Seventy patients aged
13 years and above, on NSAIDs for 4
weeks or more, and presenting with
dyspepsia were recruited and done
for endoscopies. Six biopsy specimens
were taken from each patient (2 from
each of the following sites: - corpus,
antrum and duodenum). One specimen
from each site was subjected to the
rapid urease test for H. pylori detection.
The remaining three were subjected to
histopathological evaluation.
Results: Forty male and 25 female
patients aged between 16-77 years, with
a mean age of 43.4 years were studied.
At endoscopy, only 10 (13.9%) patients
had normal gastroduodenal mucosa.
Gastritis was the most prevalent lesion
occurring in 50% of the patients. Peptic
ulcer disease had a point prevalence
of 30.5% (duodenal ulcers 22.2%, and
gastric ulcers 8.3%). Other lesions at
endoscopy were duodenitis 16.7%,
gastric erosions 5.6%, duodenal erosions
1.4% and hemorrhagic gastritis 1.4%.
At histopathology, only 5 (6.9%)
patients had normal gastroduodenal
mucosa. Chronic active gastritis was the
most prevalent lesion at 77.8%. Other
lesions were chronic gastritis 12.5%,
chemical gastritis 6.9%, duodenitis
41.7% and intestinal metaplasia 4.2%.
Prevalence of H. pylori in our study
population was 50%. There was no
association between the gastroduodenal
lesions and H. pylori infection.
Conclusions: There was a high
prevalence of gastroduodenal mucosal
lesions both at histopathology (93.1%)
and endoscopy (86.1%) in the chronic
NSAID users.

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