Use of Screening Upper Endoscopy in Gastroesophageal Reflux Disease: Best Practices

New guidance from the American College of Physicians aims to prevent unnecessary procedures and their associated complications and costs.

The utilization of esophagogastric duodenoscopy (EGD) in patients with gastroesophageal reflux disease (GERD) has increased dramatically during the last decade. Much of this increase is attributable to the use of EGD as a screening test for Barrett esophagus (BE), which is a precancerous condition. However, recent studies suggest that endoscopic surveillance for BE is overutilized (JW Gastroenterol Mar 30 2012) and that the incidence of progression from BE to esophageal adenocarcinoma has been overestimated (JW Gastroenterol Aug 19 2011).

Within this context, the American College of Physicians has released best practice advice to clinicians on appropriate referral indications for EGD in patients with GERD:

Heartburn and “alarm symptoms” (dysp…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors