OAK BROOK, Ill. December 21, 2007 The American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines for the role of endoscopy in treating dyspepsia, discomfort thought to arise from the upper-gastrointestinal tract, which affects a fourth of the population in Western countries. An upper endoscopy is a procedure which uses an instrument to evaluate the inside of the esophagus, stomach and small intestine. The guidelines, prepared by ASGE's Standards of Practice Committee, appear in the December issue of Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy.
Dyspepsia may encompass a variety of more specific symptoms, including epigastric discomfort, bloating, anorexia, and heartburn. These nonspecific symptoms can be indicative of an underlying diagnosis such as peptic ulcer disease, GERD, functional disorders (nonulcer dyspepsia), and malignancy. The appropriate role of endoscopy in the evaluation of dyspepsia is both a pragmatic concern for the gastroenterologist and an important determinant in healthcare costs.
"Since dyspepsia affects large numbers of people across a broad spectrum of symptoms, it is not practical to perform endoscopy in all patients with dyspepsia," said Todd Baron, MD, chair of the ASGE Standards of Practice Committee. "In review of the medical data available, we concluded in these guidelines that age and alarm features offer the best guidance for the physician in managing patients and in determining if an endoscopy is appropriate treatment."
Patients With Alarm Features (Symptoms)
Dyspepsia is not only a convenient descriptor for upper-gastrointestinal (GI) symptoms, but also a marker for the risk of structural disease: malignancy is present in 1 to 3 percent of patients with dyspepsia, and peptic ulcer disease in another 5 to 15 percent. Endoscopy offers the potential for early diagnosis of structural
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American Society for Gastrointestinal Endoscopy