BACKGROUND: Since the institution of open access endoscopy units there has been a considerable increase of referrals for UGI examinations. Therefore, guidelines for the appropriate use of UGI endoscopy are needed. METHODS: The outcome of first diagnostic UGI endoscopy was prospectively assessed for several referral indications in a consecutive series of 2900 patients. Indications were judged "appropriate" when significantly (p < 0.01) associated with clinically "relevant" endoscopic findings. RESULTS: The proportion of relevant disease for various indications was as follows: signs of UGI bleeding (42.2%); history of peptic ulcer (40.5%); dysphagia (31.9%), short-term (24.4%), and without therapy (20.9%). Relevant endoscopic findings were observed in 21.0% of dyspeptic patients aged 45 years or less, and in 25.3% of those older than 45 years of age. CONCLUSIONS: The generally approved alarm symptoms should be a reason to perform endoscopy without hesitation. Dyspeptic symptoms, despite adequate empiric treatment, as well as first dyspeptic symptoms in patients older than 45 years should also be a reason for endoscopic investigation. Our results support the strategy to treat patients younger than 45 years who have isolated dyspepsia by a limited course of antipeptic agents, provided that they are seen for re-evaluation within 4 to 6 weeks.
BACKGROUND: Since the institution of open access endoscopy units there has been a considerable increase of referrals for UGI examinations. Therefore, guidelines for the appropriate use of UGI endoscopy are needed. METHODS: The outcome of first diagnostic UGI endoscopy was prospectively assessed for several referral indications in a consecutive series of 2900 patients. Indications were judged "appropriate" when significantly (p < 0.01) associated with clinically "relevant" endoscopic findings. RESULTS: The proportion of relevant disease for various indications was as follows: signs of UGI bleeding (42.2%); history of peptic ulcer (40.5%); dysphagia (31.9%), short-term (24.4%), and without therapy (20.9%). Relevant endoscopic findings were observed in 21.0% of dyspeptic patients aged 45 years or less, and in 25.3% of those older than 45 years of age. CONCLUSIONS: The generally approved alarm symptoms should be a reason to perform endoscopy without hesitation. Dyspeptic symptoms, despite adequate empiric treatment, as well as first dyspeptic symptoms in patients older than 45 years should also be a reason for endoscopic investigation. Our results support the strategy to treat patients younger than 45 years who have isolated dyspepsia by a limited course of antipeptic agents, provided that they are seen for re-evaluation within 4 to 6 weeks.
Authors: S J Veldhuyzen van Zanten; N Flook; N Chiba; D Armstrong; A Barkun; M Bradette; A Thomson; F Bursey; P Blackshaw; D Frail; P Sinclair Journal: CMAJ Date: 2000-06-13 Impact factor: 8.262
Authors: M B Wallace; V L Durkalski; J Vaughan; Y Y Palesch; E D Libby; P S Jowell; N J Nickl; S M Schutz; J W Leung; P B Cotton Journal: Gut Date: 2001-07 Impact factor: 23.059
Authors: Bong Sik Matthew Kim; Bob T Li; Alexander Engel; Jaswinder S Samra; Stephen Clarke; Ian D Norton; Angela E Li Journal: World J Gastrointest Pathophysiol Date: 2014-11-15