The Changing Pattern of Upper Gastrointestinal Disorders by Endoscopy: Data of the Last 40 Years

Objectives. We have investigated the changes in the incidence of various diagnoses that have been made in the endoscopy unit throughout the last 40 years. Methods. In this study, changes in the incidence of endoscopic diagnosis in upper gastrointestinal system between 1970 and 2010 were evaluated. Their diagnosis, age, and gender data were entered into the Excel software. Results. Of the 52816 cases who underwent esophagogastroduodenoscopy in the 40-year time period, the mean age was 48.17 ± 16.27 (mean ± SD). Although overall more than half of the patients were male (54.3%), in 1995 and after a marked increase was seen in the proportion of female gender (51–55%). The presence of hiatal hernia, reflux esophagitis, and the number of Barrett’s esophaguses significantly increased. Erosive gastritis showed gradual increase, while the number of gastric ulcers decreased significantly. The presence of gastric and esophageal cancer significantly decreased. The number of duodenal ulcers significantly decreased. Conclusion. We detected that the incidences of esophagitis, Barrett’s esophagus, and erosive gastritis significantly increased while the incidences of gastric/duodenal ulcer and gastric/esophageal cancer decreased throughout the last 40 years. 1. Introduction During the last few decades, a change has been observed in the incidence of many gastrointestinal diseases, such as gastric cancer, acid-peptic disease including peptic ulcer, and gastroesophageal reflux disease [1]. Gastroesophageal reflux disease (GERD) was previously thought to be a rare disease in the East, but several recent reviews have also brought up the possibility of an increase in the prevalence of GERD. Esophagitis prevalence is reported to be 14.5% to 16.1% in patients for whom upper gastrointestinal endoscopy is performed due to dyspepsia and reflux [2–4]. Over the past three to four decades a decline in the prevalence of peptic ulcer disease in the West has been reported [5]. Similar observations have been made in the Asian-Pacific region as well [6]. The epidemiology of esophageal cancer has changed substantially over the last 50 years. It is a development that will certainly give rise to great concern. While the burden of gastric cancer remains high in the Asian Pacific region, age-standardized incidence rates have started to decline. This keeps up with observed trends in Western countries where gastric cancer has been observed to have declined since the 1940s [7]. Therefore, we retrospectively investigated the results of upper gastrointestinal system (GIS) endoscopy which was