Corelation between the Endoscopic and Histologic Diagnosis of Gastritis at the Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria

AIM AND OBJECTIVE: Endoscopists make judgements on the presence or absence of gastritis on the basis of endoscopic appearances of the gastric mucosa. Most studies in literature have shown poor concordance between endoscopic and histologic diagnosis of gastritis with concordance rates of between 54-63%. The aim of this study was to evaluate the rate of concordance between endoscopic and histologic diagnosis of gastritis at our facility given the variable but generally poor concordance reported in literature. MATERIALS AND METHODS: One hundred and seventy three consecutive patients who underwent upper gastrointestinal endoscopy and biopsy for dyspepsia at Ekiti State University Teaching Hospital (EKSUTH), Ado Ekiti, Nigeria were recruited into this study. Ethical approval for the study was obtained from the hospital's Research and Ethics Committee and all the patients gave their individual written consent. RESULTS: The mean age of the studied population was 53.02±16.28 years (age range 17-87 years). Epigastric pain was the main (86.7%) indication for referral for upper gastrointestinal endoscopy, distantly followed by belching (5.8%), early satiety (5.2%) and bloating (2.3%) respectively. At endoscopy; diffuse erythema was found in 38.7% (67/173), followed in the descending order by linear erythema in 28.3% (49/173), atrophic gastritis in 13.9% (24/173), patchy erythema in 12.7% (22/173) respectively and normal findings in 6.4% (11/173). At histology; superficial chronic active gastritis was the most common findings 74.6% (129/173) of the patients, followed by chronic atrophic gastritis 15.6% (27/173) and normal findings in 9.8% (17/173). Of the 162 that were endoscopically diagnosed as gastritis, 153 were histologically confirmed (concordance rate of 94.4%). Also, of the 156 histologically diagnosed as gastritis, 153 were endoscopically diagnosed (concordance rate of 98.1%). In all, 153 of the 173 patients were both endoscopically and histologically diagnosed as gastritis (concordance rate of 88.4%). 76.3% (119 /156) of those that were diagnosed as gastritis histologically were found to be H.pylori associated gastritis. CONCLUSIONS: In conclusion, endoscopy is a reliable predictor of histological gastritis in a population with a severe form of gastritis. We equally agreed with other authors that histology is the goal standard and mandatory for accurate diagnosis of gastritis in all cases.