Endoscopy has revolutionized the detection and treatment of digestive disorders. However, improper use can result in higher costs without advantages. Studies suggest that using upper endoscopy is not recommended for patients with symptoms of gastroesophageal reflux disorder (GERD) and is beneficial only in specific situations.
To assist physicians in avoiding the excessive use of procedures that have no effect on health outcomes. The American College of Physicians (ACP) recently issued guidelines regarding the proper use of upper endoscopy among patients suffering from GERD symptoms.
Upper endoscopy is a possibility to identify Barrett Esophagus as well as esophageal adenoma in males older than 50 who have had symptoms for longer than five years and also have risks (e.g. nighttime reflux, Hiatal hernias an elevated the body mass index (BMI), smoking consumption, and intra-abdominal weight distribution). It could also be recommended to monitor women and men who have a previous history of Barrett Esophagus. If there isn’t any dysplasia the need for serial endoscopy should be performed no more often than once 3 to 5 times per year. If dysplasia is detected it is recommended to have more frequent intervals recommended due to the greater chance of cancer progression.
Multiple cohort studies have proven that upper endoscopy doesn’t typically reveal Barrett Esophagus or esophageal adenocarcinoma in patients who aren’t identified as having the conditions at first. Get an Additionally, regular endoscopic examination of patients with nondysplastic Barrett the esophagus has shown a low percentage of malignant changes. Endoscopy that is not needed exposes patients to unavoidable injuries including complications related to perforation, sedation, bleeding,, and aspiration of the lungs. A misdiagnosis and subsequent ineffective treatment are also possible like financial difficulties resulting due to increased insurance costs following the diagnosis of Barrett’s esophagus.
Read Related Article: What is Esophagogastroduodenoscopy (EGD)?
Every patient who presented to our department with a request for surgical weight loss was screened by our bariatric staff. Surgery for bariatrics was provided to patients who met the criteria set forth in our hospital bariatric department procedure and were deemed by the bariatric staff as candidates for the procedure (patients with a body mass index (BMI). That have had comorbidities known to them or those with a BMI of > 40kg/m 2 with no known co-morbidities). The kind of procedure was discussed and agreed upon between patients and the bariatric team following conducting all tests.
Gastroscopy is performed routinely at our hospital prior to any bariatric surgery to examine the upper part of the gastrointestinal tract to determine any unusual findings. Gastroscopy was carried out by skilled endoscopists within our gastroenterology department, under local anesthesia using a spray with or without sedation. The findings were recorded in the medical database.
The test for Campylobacter-like organisms (CLO test) to identify H. Pylori was conducted during all endoscopic procedures. The data collected comprised the patient’s age, sex, preoperative BMI, and all gastroscopy results as well as the length of time of the endoscopy and any complications.
Patients were classified into three groups based on the results of the gastroscopy. Group 0 was comprised of patients with normal endoscopy. Group 1 comprised patients who had endoscopic findings that weren’t important and that did not affect the plan of procedure The second group included patients who had significant findings that had an impact on the procedure in a way (procedure delayed or canceled, or the procedure changed). If there were multiple gastroscopy findings the most significant abnormality that had the biggest effect on the procedure of bariatrics was selected for the purpose of counting and data analysis.
In discussing the possibility of upper endoscopy in patients suffering from GERD doctors should stress that the chance of developing esophageal cancer among people suffering from heartburn is minimal. That patients don’t have to be examined for GERD regularly as they are for other chronic illnesses. Patients should be advised that in the event of extreme esophageal irritations acid suppression treatment is the most effective option. That endoscopy typically does not alter the treatment plan. Doctors must explain to patients suffering from Barrett the esophagus that performing an endoscopy more frequently than once every three or five years will not mean that you are preventing more cancers as does screening less frequently.
An upper endoscopy can be used in patients suffering from heartburn as well as alarm signs. (e.g. dysphagia or dysphagia bleeding anemia weight loss, persistent vomiting). But, it’s not the best first choice for the majority of patients suffering from GERD and is recommended only if empiric treatment by using proton-pump inhibitors (PPIs) used twice daily for between four and eight weeks is not effective in reducing symptoms.
Endoscopy may also be recommended in patients who have had a history of esophageal tighter. That have dysphagia-related symptoms that are recurrent or those suffering from severe erosive esophagitis that has completed a two-month program of PPI therapy. Which to determine the extent of healing and exclude Barrett the esophagus. A repeat endoscopy following the follow-up exam is not recommended in the absence of Barrett the esophagus.
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