Gupta Kamesh, Groudan Kevin, Jobbins Kathryn, Hans Bandhul, Singhania Rohit
Department of Medicine, University of Massachusetts-Baystate, Springfield, MA, USA.
These authors contributed equally to this manuscript.
Gastroenterology Res. 2021 Apr;14(2):81-86. doi: 10.14740/gr1370. Epub 2021 Apr 21.
We compared real-world practice of dyspepsia management to the new American College of Gastroenterology (ACG)/Canadian Association of Gastroenterology (CAG) guidelines 2017.
We conducted a retrospective, observational study using administrative data to include patients undergoing esophagogastroduodenoscopy (EGD) for dyspepsia.
Out of 122 EGDs, only 30 (24.5%) were deemed appropriate per guidelines. Only 13 (14.1%) patients had undergone both () test and treat and adequate proton pump inhibitor (PPI) before undergoing endoscopy. Nineteen (15.5%) patients had alarm symptoms (weight loss, melena and early satiety). Positivity rate of was 36.3%, but only half completed treatment. Twenty-six patients (21.3%) had abnormalities on endoscopy, most commonly gastritis. There were no cases of gastric/esophageal cancer.
The rate of inappropriate upper gastrointestinal endoscopy is higher than the existing literature, likely because of the stricter use of EGD in patients < 60 years. Only one in eight patients underwent the recommended workup before undergoing endoscopy.
我们将消化不良管理的实际临床实践与美国胃肠病学会（ACG）/加拿大胃肠病学会（CAG）2017年的新指南进行了比较。
我们利用管理数据开展了一项回顾性观察性研究，纳入因消化不良接受食管胃十二指肠镜检查（EGD）的患者。
在122例EGD检查中，根据指南只有30例（24.5%）被认为是合适的。只有13例（14.1%）患者在接受内镜检查前进行了幽门螺杆菌检测及治疗并使用了足量质子泵抑制剂（PPI）。19例（15.5%）患者有警示症状（体重减轻、黑便和早饱）。幽门螺杆菌阳性率为36.3%，但只有半数完成了治疗。26例（21.3%）患者内镜检查有异常，最常见的是胃炎。没有胃癌/食管癌病例。
不适当的上消化道内镜检查率高于现有文献报道，可能是因为对60岁以下患者更严格地使用了EGD。只有八分之一的患者在接受内镜检查前进行了推荐的检查。
