Skip to main content
The BMJ logoLink to The BMJ
. 1995 Apr 1;310(6983):853–856. doi: 10.1136/bmj.310.6983.853

Guidelines on appropriate indications for upper gastrointestinal endoscopy. Working Party of the Joint Committee of the Royal College of Physicians of London, Royal College of Surgeons of England, Royal College of Anaesthetists, Association of Surgeons, the British Society of Gastroenterology, and the Thoracic Society of Great Britain.

A T Axon 1, G D Bell 1, R H Jones 1, M A Quine 1, R F McCloy 1
PMCID: PMC2549224  PMID: 7711627

Abstract

Upper gastrointestinal endoscopy is a valuable diagnostic tool, but for an endoscopy service to be effective it is essential that it is not overloaded with inappropriately referred patients. A joint working party in Britain has considered the available literature on indications for endoscopy, assessed standard practice through a questionnaire, and audited randomly selected cases using an independent panel of experts and an American database system. They used these data to produce guidelines on the appropriate and inappropriate indications for referral for endoscopy, although they emphasise that under certain circumstances there may be reasons to deviate from the advice given. The need for endoscopy is most difficult to judge in patients with dyspepsia, and this aspect is discussed in detail. Early endoscopy will often prove more cost effective than delaying until the indications are clearer.

Full text

PDF
853

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brook R. H., Park R. E., Chassin M. R., Solomon D. H., Keesey J., Kosecoff J. Predicting the appropriate use of carotid endarterectomy, upper gastrointestinal endoscopy, and coronary angiography. N Engl J Med. 1990 Oct 25;323(17):1173–1177. doi: 10.1056/NEJM199010253231705. [DOI] [PubMed] [Google Scholar]
  2. Fischer A., Graem N. Gastric stump carcinoma--is prophylactic screening indicated? Acta Chir Scand Suppl. 1988;547:86–87. [PubMed] [Google Scholar]
  3. Hallissey M. T., Allum W. H., Jewkes A. J., Ellis D. J., Fielding J. W. Early detection of gastric cancer. BMJ. 1990 Sep 15;301(6751):513–515. doi: 10.1136/bmj.301.6751.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Heading R. C. Definitions of dyspepsia. Scand J Gastroenterol Suppl. 1991;182:1–6. doi: 10.3109/00365529109109529. [DOI] [PubMed] [Google Scholar]
  5. Heatley R. V., Rathbone B. J. Dyspepsia: a dilemma for doctors? Lancet. 1987 Oct 3;2(8562):779–782. doi: 10.1016/s0140-6736(87)92509-8. [DOI] [PubMed] [Google Scholar]
  6. Jones R. What happens to patients with non-ulcer dyspepsia after endoscopy? Practitioner. 1988 Jan;232(1441):75-6, 78. [PubMed] [Google Scholar]
  7. Logan R. F., Langman M. J. Screening for gastric cancer after gastric surgery. Lancet. 1983 Sep 17;2(8351):667–670. doi: 10.1016/s0140-6736(83)92541-2. [DOI] [PubMed] [Google Scholar]
  8. Management of dyspepsia: report of a working party. Lancet. 1988 Mar 12;1(8585):576–579. [PubMed] [Google Scholar]
  9. Manning A. P., Thompson W. G., Heaton K. W., Morris A. F. Towards positive diagnosis of the irritable bowel. Br Med J. 1978 Sep 2;2(6138):653–654. doi: 10.1136/bmj.2.6138.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Maruyama K., Okabayashi K., Kinoshita T. Progress in gastric cancer surgery in Japan and its limits of radicality. World J Surg. 1987 Aug;11(4):418–425. doi: 10.1007/BF01655804. [DOI] [PubMed] [Google Scholar]
  11. Nyrén O., Lindberg G., Lindström E., Marké LA, Seensalu R. Economic costs of functional dyspepsia. Pharmacoeconomics. 1992 May;1(5):312–324. doi: 10.2165/00019053-199201050-00003. [DOI] [PubMed] [Google Scholar]
  12. Offerhaus G. J., Tersmette A. C., Giardiello F. M., Huibregtse K., Vandenbroucke J. P., Tytgat G. N. Evaluation of endoscopy for early detection of gastric-stump cancer. Lancet. 1992 Jul 4;340(8810):33–35. doi: 10.1016/0140-6736(92)92433-g. [DOI] [PubMed] [Google Scholar]
  13. Quine M. A., Bell G. D., McCloy R. F., Devlin H. B., Hopkins A. Appropriate use of upper gastrointestinal endoscopy--a prospective audit. Steering Group of the Upper Gastrointestinal Endoscopy Audit Committee. Gut. 1994 Sep;35(9):1209–1214. doi: 10.1136/gut.35.9.1209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sobala G. M., Crabtree J. E., Pentith J. A., Rathbone B. J., Shallcross T. M., Wyatt J. I., Dixon M. F., Heatley R. V., Axon A. T. Screening dyspepsia by serology to Helicobacter pylori. Lancet. 1991 Jul 13;338(8759):94–96. doi: 10.1016/0140-6736(91)90085-4. [DOI] [PubMed] [Google Scholar]
  15. Sue-Ling H. M., Johnston D., Martin I. G., Dixon M. F., Lansdown M. R., McMahon M. J., Axon A. T. Gastric cancer: a curable disease in Britain. BMJ. 1993 Sep 4;307(6904):591–596. doi: 10.1136/bmj.307.6904.591. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Sue-Ling H. M., Martin I., Griffith J., Ward D. C., Quirke P., Dixon M. F., Axon A. T., McMahon M. J., Johnston D. Early gastric cancer: 46 cases treated in one surgical department. Gut. 1992 Oct;33(10):1318–1322. doi: 10.1136/gut.33.10.1318. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Talley N. J., Weaver A. L., Tesmer D. L., Zinsmeister A. R. Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy. Gastroenterology. 1993 Nov;105(5):1378–1386. doi: 10.1016/0016-5085(93)90142-y. [DOI] [PubMed] [Google Scholar]
  18. de Dombal F. T., Price A. B., Thompson H., Williams G. T., Morgan A. G., Softley A., Clamp S. E., Unwin B. J. The British Society of Gastroenterology early gastric cancer/dysplasia survey: an interim report. Gut. 1990 Jan;31(1):115–120. doi: 10.1136/gut.31.1.115. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES