Prevalence of upper gastrointestinal disease in relation to age: Endoscopic and clinical implications

Reports of 2005 endoscopies were reviewed to determine the age-related prevalence of upper gastrointestinal (UGI) disease as a guide to medical officers in primary and secondary centres for necessary referral to us for endoscopic examination. Results indicated that (1) there were positive findings in 1836 (92 percent) of all endoscopic examinations, and most symptomatic patients can be expected to have at least one UGI abnormality, (2) many patients with UGI symptoms have two or more reportable disease processes, (3) the prevalence of serious or life-threatening diseases such as cancer or large ulcers rises steasily with age, and (4) after age 50 approximately 51 percent of symptomatic patients have a serious UGI disease. Based on these findings, one should expect to diagnose at least one abnormality in most symptomatic patients, and should manage younger patients in their centres as an alternative. However, one should not hesitate to refer patients above 50 to an appropriate centre. Because of high prevalence of serious lesions in the elderly, endoscopy should also be condidered for the initial examination of an elderly patient if poor physical status renders the radiological examination difficult or unreliable.