Appropriateness of indications for diagnostic upper gastrointestinal endoscopy: association with relevant endoscopic disease

Gastrointest Endosc. 1995 Nov;42(5):390-7. doi: 10.1016/s0016-5107(95)70037-4.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Endoscopy, Gastrointestinal / standards*
  • Endoscopy, Gastrointestinal / statistics & numerical data
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Prospective Studies
  • Referral and Consultation / standards
  • Referral and Consultation / statistics & numerical data