Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Upper endoscopy guidelines for GERD

This month's issue of the Annals of Internal Medicine reviews best practice advice on upper endoscopy in GERD from clinical guidelines committee of the American College of Physicians.

News image

Upper endoscopy is commonly used in the diagnosis and management of gastroesophageal reflux disease (GERD).

Evidence demonstrates that it is indicated only in certain situations, and inappropriate use generates unnecessary costs and exposes patients to harms without improving outcomes.

The Clinical Guidelines Committee of the American College of Physicians reviewed evidence regarding the indications for, and yield of, upper endoscopy in the setting of GERD.

Dr Nicholas Shaheen and colleagues highlighted how clinicians can increase the delivery of high-value health care.

The team report on best practice advice 1 that upper endoscopy is indicated in men and women with heartburn and alarm symptoms.

The team also examined best practice advice 2, where upper endoscopy is indicated in men and women with typical GERD symptoms that persist despite a therapeutic trial of 4 to 8 weeks of twice-daily proton-pump inhibitor therapy.

Upper endoscopy is indicated in men and women with severe erosive esophagitis after a 2-month course of proton-pump inhibitor therapy to assess healing and rule out Barrett esophagus.

Recurrent endoscopy after this follow-up examination is not indicated in the absence of Barrett esophagus.

In Barrett esophagus with no dysplasia, surveillance should occur at intervals of 3 to 5 years
Annals of Internal Medicine

The team report that upper endoscopy is also indicated in men and women with a history of esophageal stricture who have recurrent symptoms of dysphagia.

The research team reviewed best practice advice 3, which recommends upper endoscopy in men older than 50 years with chronic GERD symptoms, and additional risk factors to detect esophageal adenocarcinoma and Barrett esophagus.

Upper endoscopy is also indicted for surveillance evaluation in men and women with a history of Barrett esophagus.

The team report that in men and women with Barrett esophagus and no dysplasia, surveillance examinations should occur at intervals no more frequently than 3 to 5 years.

More frequent intervals are indicated in patients with Barrett esophagus and dysplasia.

Endoscopy is indicated in typical GERD symptoms that persist despite a therapeutic trial of 4 to 8 weeks of twice-daily proton-pump inhibitor therapy.

Severe erosive esophagitis after a 2-month course of proton-pump inhibitor therapy indicates endoscopy to assess healing and rule out Barrett esophagus.

Recurrent endoscopy after this follow-up examination is not indicated in the absence of Barrett esophagus.

The research team reports that surveillance is indicated in patients with a history of esophageal stricture who have recurrent symptoms of dysphagia.

Surveillance is also indicated in men older than 50 years with chronic GERD symptoms, and additional risk factors to detect esophageal adenocarcinoma and Barrett esophagus.

Surveillance evaluation is further indicated in men and women with a history of Barrett esophagus.

In men and women with Barrett esophagus and no dysplasia, surveillance examinations should occur at intervals no more frequently than 3 to 5 years.

More frequent intervals are indicated in patients with Barrett esophagus and dysplasia.

The team report that upper endoscopy is commonly used in the diagnosis and management of gastroesophageal reflux disease (GERD).

Dr Shaheen's team concludes, "The Clinical Guidelines Committee of the American College of Physicians reviewed evidence regarding the indications for, and yield of, upper endoscopy in the setting of GERD to highlight how clinicians can increase delivery of high-value care."

"This article reviews their best practice advice."

Ann Int Med 2012: 157(11): 808-816
06 December 2012

Go to top of page Email this page Email this page to a colleague

 23 April 2014

Advanced search
 23 April 2014 
Cancer risk after resection of polypoid dysplasia
 23 April 2014 
Fecal microbiota transplantation therapy
 23 April 2014 
Colorectal cancer risk in MUTYH mutation carriers
 22 April 2014 
Endoscopy guidelines to select patients for colonoscopy
 22 April 2014 
PPI use and cancer in Barrett's
 22 April 2014 
Ledipasvir and sofosbuvir for HCV genotype 1
 17 April 2014 
Screening for low bone mineral density among ulcerative colitis
 17 April 2014 
Diabetes mellitus and acute pancreatitis
 17 April 2014 
Bowel cleansing for colonoscopy
 16 April 2014 
Evaluating pharmacologic agents in IBS
 16 April 2014 
Isotretinoin and IBD risk
 16 April 2014 
Mortality in bleeding Mallory-Weiss syndrome vs peptic ulcer bleeding
 15 April 2014 
Dietary fat and risk of IBD
 15 April 2014 
Quality of life in microscopic colitis
 15 April 2014 
New prognostic score for cirrhosis
 14 April 2014 

5-aminosalicylates in early pregnancy and congenital malformation risk

 14 April 2014 
Changing liver cancer mortality rates in the United States
 14 April 2014 
Inflammatory sacroiliitis by MRI in IBD
 11 April 2014 
H pylori resistance to antibiotics
 11 April 2014 
Predictors of corticosteroid treatment outcomes for ulcerative colitis
 11 April 2014 
Antibiotic combination therapy for ulcerative colitis
 10 April 2014 
Mortality in Crohn's disease
 10 April 2014 
Prophylaxis against venous thromboembolism in hospitalized ulcerative colitis
 10 April 2014 
Probiotic treatment and infant colic
 09 April 2014 
Preventing death in general intensive care
 09 April 2014 
Neoplasm risk after polypectomy
 09 April 2014 
Disclosure program and gastroenterology-related claims
 08 April 2014 

Regurgitation and health-related quality of life in GERD

 08 April 2014 
H. pylori resistance to antibiotics
 08 April 2014 
Management of chronic diarrhea
 07 April 2014 
Gastrointestinal angiodysplastic lesions
 07 April 2014 
Meat intake and liver cancer
 07 April 2014 
Adenoma detection and colorectal cancer risk
 04 April 2014 
Stool DNA tests for colorectal cancer
 04 April 2014 
PET-CT predicts outcome in colorectal liver metastases
 04 April 2014 

Prophylaxis of post-ERCP pancreatitis

 03 April 2014 
Management of esophageal or gastric variceal bleeding
 03 April 2014 
Exclusionary diets for IBD
 03 April 2014 
Mortality with chronic pancreatitis
 02 April 2014 
Disease course of early-onset pediatric IBD
 02 April 2014 
Risk of liver fibrosis progression in chronic hep B
 02 April 2014 
Colorectal cancer and patient survival
 01 April 2014 
Outcomes in patients with Hep C
 01 April 2014 
Diagnosis of functional dyspepsia
 01 April 2014 
Genetic risk factors for stenosis and infections in primary sclerosing cholangitis
 31 March 2014 
Diet-gene interactions and Crohn's
 31 March 2014 
Transjugular intrahepatic portosystemic stent-shunts in Budd–Chiari syndrome
 31 March 2014 
Hepatic decompensation in antiretroviral-treated patients
 28 March 2014 
Glucocorticoids and mortality after colorectal cancer surgery
 28 March 2014 
Long-term metformin use and gastric cancer risk
 28 March 2014 
Distance from a liver transplant center and survival
 27 March 2014 
Radiofrequency ablation vs endoscopy for Barrett's
 27 March 2014 
Omega-3 fatty acid and Crohn's disease
 27 March 2014 
Thromboembolism prophylaxis in IBD
 26 March 2014 
Disparities in evaluation of rectal bleeding
 26 March 2014 
Prediction of H. pylori status after endoscopy
 26 March 2014 
Fatigue and depression in IBD
 25 March 2014 
Depression risk in IBD
 25 March 2014 
Fecal incontinence in the USA
 25 March 2014 
Circulating gastrin and colorectal carcinoma risk

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us