Endoscopic findings of acid peptic disease at low and high altitude: Kathmandu versus Rasuwa districts of Nepal

Endoscopic findings of APD at low and high altitude



Acid Peptic Disease (APD), Endoscopy, High Altitude, Kathmandu Valley, Rasuwa District, Nepal



Introduction: Features of Acid Peptic Disease (APD) have specific presentations from low to high altitudes. This study aims to compare the endoscopy findings of APD at low altitudes (Kathmandu Valley) and High Altitudes (Rasuwa District) of Nepal.


Method: Endoscopy findings of APD patients from Nov 2017 to Dec 2021 at Manmohan Medical College and Teaching Hospital (MMTH) were reviewed from the data kept in the endoscopy unit to compare the findings among patients from low altitudes (Kathmandu valley) and high altitudes (Rasuwa district). Variables included were age, sex, and endoscopy findings of APD. Microsoft Excel was used for data analysis. Chi-square analysis was used for the association between APD findings and altitude. A p-value ≤0.05 was considered statistically significant.


Result: Out of 2937 APD patients, 1560 (53.1%) were male and 1377(46.9%) female, age 48.5 years (range 16-81) with 2701(91.6%) having endoscopic findings of APD. Among 2701 APDs, 1448 (88.6%) were from the low altitude of Kathmandu valley, and 1253 (96.2%) were from high altitude (Rasuwa district), p-value <0.0002. There were 736(50.8%) patients with gastritis from Kathmandu vs. 695 (55.46%) from Rasuwa, followed by gastro-duodenitis 219(15.1%) vs. 32 (2.5%), duodenitis 171 (11.8%) vs. 169(13.5%) respectively.


Conclusion: The incidence of endoscopic findings of overall APD was high among patients from the high altitude of Rasuwa district compared to the low altitude Kathmandu valley of Nepal.


Keywords: Acid Peptic Disease (APD), endoscopy, high altitude, Kathmandu valley, Rasuwa district, Nepal


Author Biographies

Dharma Datta Subedi, Karnali Academy of Health Sciences, Jumla, Nepal

Professor, Department of General Practice and Emergency Medicine

Jay Narayan Shah, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal

Professor, Department of Surgery, Patan Hospital



Muza Shrestha, Manmohan Medical College and Teaching Hospital, Kathmandu, Nepal

Professor, Department of Surgery

Biyush Pokharel, Manmohan Medical College and Teaching Hospital, Kathmandu, Nepal

Medical Officer, Department of Emergency

Prabodh Regmi, National Academy of Medical Sciences, Kathmandu, Nepal

Assistant Professor, Department of Urology, Bir Hospital

Ram Naresh Pandit






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