Upper Endoscopy for Gastroesophageal Reflux Disease
Authors: Gabor Kandel
Journal: Annals of Internal Medicine (2013)

Letters19 March 2013Upper Endoscopy for Gastroesophageal Reflux DiseaseGabor Kandel, MDGabor Kandel, MDFrom St. Michael's Hospital, Toronto, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-6-201303190-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Shaheen and colleagues (1) thoughtfully illuminate a perplexing problem. However, I believe that 2 further indications for upper endoscopy to evaluate gastroesophageal reflux should be considered.First, upper endoscopy may be more reassuring and more cost-effective for patients worried about cancer than explanation alone. In a study of gastric acid suppressants versus immediate gastroscopy for dyspepsia, Bytzer and colleagues (2) found that the group assigned to endoscopy was not only more satisfied with medical care but also had lower health care costs, in part because of decreased drug costs, sick days, and physician follow-ups presumably from the ...References1. Shaheen NJ, Weinberg DS, Denberg TD, Chou R, Qaseem A, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Upper endoscopy for gastroesophageal reflux disease: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2012;157:808-16. [PMID: 23208168] LinkGoogle Scholar2. Bytzer P, Hansen JM, Schaffalitzky de Muckadell OB. Empirical H2-blocker therapy or prompt endoscopy in management of dyspepsia. Lancet. 1994;343:811-6. [PMID: 7980747] CrossrefMedlineGoogle Scholar3. Lagergren J, Bergström R, Lindgren A, Nyrén O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825-31. [PMID: 10080844] CrossrefMedlineGoogle Scholar4. James P, Cirocco M, Kandel G, Kortan P, May G, Marcon N. Early adenocarcinoma and high grade dysplasia among adults less than 55 years of age [Abstract]. Can J Gastroenterol. 2012;26 Suppl 26 A227. Google Scholar5. Thomson AB, Barkun AN, Armstrong D, Chiba N, White RJ, Daniels S, et al. The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian Adult Dyspepsia Empiric Treatment-Prompt Endoscopy (CADET-PE) study. Aliment Pharmacol Ther. 2003;17:1481-91. [PMID: 12823150] CrossrefMedlineGoogle Scholar6. Niklasson A, Lindström L, Simrén M, Lindberg G, Björnsson E. Dyspeptic symptom development after discontinuation of a proton pump inhibitor: a double-blind placebo-controlled trial. Am J Gastroenterol. 2010;105:1531-7. [PMID: 20332770] CrossrefMedlineGoogle Scholar7. Reimer C, Søndergaard B, Hilsted L, Bytzer P. Proton-pump inhibitor therapy induces acid-related symptoms in healthy volunteers after withdrawal of therapy. Gastroenterology. 2009;137:80-7. [PMID: 19362552] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gabor Kandel, MDAffiliations: From St. Michael's Hospital, Toronto, Ontario, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpper Endoscopy for Gastroesophageal Reflux Disease: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians Nicholas J. Shaheen , David S. Weinberg , Thomas D. Denberg , Roger Chou , Amir Qaseem , Paul Shekelle , and Upper Endoscopy for Gastroesophageal Reflux Disease Nicholas J. Shaheen and David S. Weinberg Metrics 19 March 2013Volume 158, Issue 6Page: 502-503KeywordsDrugsEndoscopyEsophageal cancerEsophagusGastroenterology and hepatologyGastroesophageal reflux diseaseMucous membranesPrimary care physiciansProton pump inhibitorsRespiratory system procedures ePublished: 19 March 2013 Issue Published: 19 March 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...