Predominance of Upper Gastrointestinal Endoscopy for Dysphagia and Esophageal Disease: A 5-Year Analysis at a Private Hospital in Western Kenya (2020–2024)

Background: Gastrointestinal endoscopy is essential for diagnosing upper and lower GI disorders in resource-limited settings, where upper GI conditions predominate but lower GI screening remains underutilised. Esophagogastroduodenoscopy (EGD) is a diagnostic procedure carried out to visualise the mucosal lining of the oesophagus, stomach, and proximal duodenum. Objective: This retrospective descriptive study evaluated diagnostic data from 5,544 patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy between March 2020 and March 2024 at a private hospital in Kisii County, Kenya. The study aimed to evaluate the use of procedures, patient profiles, clinical reasons, and diagnostic outcomes to inform practice and planning for healthcare and resources. Methods: Data extracted were patient age, gender, pre-medication, reasons for endoscopy, results, provisional diagnoses, and clinical impressions. Data were analysed using SPSS version 25. Results: Results demonstrated a very strong predominance of EGD procedures (98.8%) over colonoscopy (1.2%), reflective of a very strong imbalance between access and utilisation. The extreme disparity suggests potential underuse of colonoscopy, most likely attributable to limited equipment, specialist access, and referral patterns. Dysphagia was the most frequent clinical indication for EGD, in excess of 43% of cases, with malignancy and peptic ulcers representing a substantial disease burden. Referral indications were highly aligned with diagnostic results, reflective of the clinical importance of current referral patterns. The gender ratio was approximately equal, and the 41–80 years age category was found to be a priority group for interventions. Conclusion: The findings highlight the need to strengthen diagnostic capacity for dysphagia and oesophageal diseases, optimise protocols for upper gastrointestinal bleeding and hematemesis, promote early evaluation and management of functional dyspepsia and epigastralgia, and invest in comprehensive oesophageal cancer services. Enhanced access and awareness of colonoscopy, standardisation of documentation and data management, implementation of quality indicators, and regular training are needed to improve patient outcomes.