Endoscopic findings and prevalence of Helicobacter pylori among dyspeptic patients in Nepal: A cross-sectional study

Background Dyspepsia is a prevalent gastrointestinal issue with a variety of underlying causes, which can range from functional disorders to significant organic diseases. The objective of this study was to identify the underlying causes of dyspepsia by evaluating the prevalence of Helicobacter pylori infection and examining associated endoscopic and histopathological findings in affected patients. Methods A cross-sectional study involving 555 adult patients who presented with dyspepsia at two healthcare facilities in Nepal was carried out. All participants underwent upper gastrointestinal endoscopy, during which targeted biopsies were collected from the esophagus, stomach, and duodenum depending upon the endoscopic findings. Histological analysis via Giemsa stain was conducted to detect H. pylori. The relationships between H. pylori status and various clinical, endoscopic, and histopathological findings were assessed via chi-square tests. Results The average age of the participants was 45.7 ± 15.2 years, with a predominance of females (58.2%). The most common endoscopic finding was gastritis (93.0%), followed by hiatus hernia (65.8%), esophagitis (59.0%), ulcers (39.6%), duodenitis (27.9%), and erosions (13.0%). H. pylori infection was identified in 16.8% of the patients. The type of peptic ulcer differed significantly by sex (p = 0.040), with gastric ulcers occurring frequently in females and duodenal or mixed ulcers occurring more frequently in males. A statistically significant correlation was found between H. pylori infection and histopathologic characteristics, including active chronic gastritis (p < 0.01), inactive chronic gastritis (p < 0.01), and atrophy (p < 0.01). However, no significant association was observed between H. pylori and endoscopic findings such as gastritis, duodenitis, or ulceration (p > 0.05). Conclusion Organic abnormalities are frequently noted among patients with dyspepsia, with gastritis being the most prominent endoscopic feature. Although H. pylori infection strongly correlated with histologic indicators of chronic gastritis and atrophy, its association with endoscopic findings is limited. These findings underscore the importance of histopathological evaluation in the thorough assessment of dyspepsia.