Background: Dyspepsia is a prevalent gastrointestinal condition with multiple differential diagnoses and mixed pathophysiology. It is divided into organic and functional types, with functional type being more common.

Objectives: This study aims to investigate the diagnostic value of endoscopy in dyspeptic patients without alarming symptoms, the frequency of endoscopic findings, and their association with various patient variables.

Methods: A cross-sectional descriptive study during a four months period was conducted on 100 dyspeptic patients without alarm features at Al-Sader Teaching Hospital and Basra Specialized Gastrointestinal Teaching Hospital. Patients with alarming symptoms, had a known cause of dyspepsia, had a history of abdominal surgery and those who are unfit for endoscopy were excluded from the study. The patients' demographic data, gastrointestinal symptoms, history of chronic illness, drug use, smoking, and alcohol were recorded. Endoscopic findings were observed, and statistical analysis was performed using SPSS 23.0 software.

Results: A total of 100 patients (54 male and 46 female) spanning a wide age range were included in this study. The majority of the patients were residing in urban areas (56%). The educational background was diverse, with a significant proportion having completed only primary school (36%). A predominant portion were non-employed (61%). Among the reported symptoms, epigastric pain was the most frequently reported symptom (60%), followed by post-prandial fullness (43%). Co-morbidities were present in 21% of cases, with diabetes mellitus being the most frequently observed (8 patients). 20 patients were smokers, 1 alcoholic and 15 were taking NSAIDs. Among the patients, 40% had normal endoscopic findings, while the remaining exhibited various abnormalities. The most common abnormalities were gastritis (15%), duodenal ulcer (14%), esophagitis (12%), and hiatal hernia (11%). Age, educational level, occupational status, smoking, and NSAIDs use were significantly associated with abnormal endoscopic findings. Sex, residency, and the presence of co-morbidity did not show significant associations.

Conclusion: Endoscopy remains a valuable diagnostic tool for dyspeptic patients without alarm features, aiding in early detection and tailored treatment approaches for organic disorders. This study highlights the importance of considering patient variables when evaluating and managing dyspeptic patients. Further research is needed to explore additional factors contributing to organic dyspepsia.