Upper Endoscopic Lesions in the Elderly

Abstract

Introduction : advanced age is characterized by physiological changes and increased susceptibility to specific lesions. The aim of this study was to describe the practice of upper gastrointestinal endoscopy (UGIE) in patients aged 60 or over in two digestive endoscopy units in Zinder, Niger. Methodology : this was a cross-sectional study with retrospective data collection carried out from January 1, 2020 to December 31, 2022, including subjects aged 60 and over who had undergone UGIE. Results : The study covered 184 reports from a total of 1,331 upper gastrointestinal endoscopies, representing a frequency of endoscopy in the elderly of 13.82%. The mean age of patients was 66.14 ± 6.81 years, with extremes of 60 and 90 years. The sex ratio was 1.62. 85.33% (n = 157) of patients were from rural areas and 85.87% had no fixed income. Epigastralgia in 51.35% (n = 114) and vomiting in 10.81% (n = 26) were the main indications. Endoscopic examination revealed lesions in 90.77% (n = 167). Gastric involvement, dominated by gastropathic lesions in 53.80% (n = 99), accounted for 73.36% (n = 135) and esophageal involvement 16.30% (n = 30). Inflammatory pathology accounted for 62.87% (n = 105), followed by peptic ulcer disease in 12.57% (n = 21) and tumor pathology in 10.77% (n = 18). Biopsies were performed in 16.3% (n = 30). Histological results from twenty-four patients (80%) revealed fourteen gastric adenocarcinomas, four esophageal squamous cell carcinomas, five cases of chronic Helicobacter pylori gastritis and one hyperplastic polyp. Conclusion : upper endoscopic lesions in the elderly are dominated by inflammatory pathology. This inflammatory pathology can sometimes mask tumoral lesions, hence the need for systematic biopsies in the presence of any macroscopic lesion when the subject is symptomatic, all the more so in the elderly.