Criteria for requesting upper digestive Endoscopy in the diagnosis of dyspeptic Syndrome: A literature review

Abstract

Abstract— Dyspepsia is defined by any disorder of digestion in the gastrointestinal tract or gastric sensitivity, and is divided into two groups: secondary dyspepsia, which are specific lesions such as peptic ulcer, esophagitis, gastric cancer, and cholelithiasis that result from different diseases, and functional dyspepsia. For the diagnosis of functional dyspepsia, the Rome IV criteria should be adopted. For the diagnosis of functional dyspepsia, the patient must have one or more of the following symptoms: a nagging sensation of postprandial fullness, early satiety, epigastric burning, and no evidence of structural disease that would explain the symptoms. There are signs and symptoms that the physician must be alert to in order to investigate more serious diseases that require earlier therapeutic measures, such as neoplasms. These signs are characterized as "alarm signals" and among them are, for example: unintentional weight loss, dysphagia, odynophagia, persistent vomiting, hematemesis, family history of cancer of the gastrointestinal tract. The use of upper endoscopy is one of the most common methods for investigating dyspepsia, but it should not be requested for all patients indiscriminately. Given this, the objective of this research was to identify the alarm signs and analyze the main criteria used for the request of upper gastrointestinal endoscopy in dyspeptic patients in order to reduce the impacts before the investigation and clinical management performed. For this, a systematic review of the literature was performed from a search in the Scielo database, using the descriptors "upper digestive endoscopy" and "dyspepsia", finding a total of 15 studies published in the period 2010 to 2020 and after reading the title and abstract, 14 articles were selected for presenting greater relevance and affinity with the subject under study. The inclusion criteria used were productions in the public domain that dealt with the proposed theme, works written in several languages and productions available in full, thus excluding the documents that did not meet the above criteria. The literature analysis allowed us to identify the main alarm signs and to identify the criteria used to request upper digestive endoscopy.