PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 12695804

Upper gastrointestinal endoscopy: current status.

John D Mellinger
View original source ↗Export metadata ↓

Abstract

Esophagogastroduodenoscopy occupies a predominant position in the diagnostic evaluation and therapeutic management of foregut disease. The safety, anatomic refinement, and tissue sampling capabilities offered by endoscopic examination support its use as a premier diagnostic tool. An increasingly diverse and ingenious set of endoscopically delivered tools are available to expand the diagnostic capability, and extend the therapeutic application of esophagogastroduodenoscopy to a wide range of pathology, both benign and neoplastic. Comparative outcome data support the utility of therapeutic esophagogastroduodenoscopy in the management of upper gastrointestinal bleeding and the palliative management of foregut neoplasia. Endoscopically delivered therapies may have an increasing role in the management of gastroesophageal reflux disease in the future, and the development of endoluminal ultrasound has added a whole new dimension to endoscopic diagnostic and, potentially, therapeutic capability. This review highlights the current status of esophagogastroduodenoscopy in the diagnosis and management of upper gastrointestinal pathology.

Explore related subjects

Endoscopy, Digestive SystemGastrointestinal DiseasesHumansJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

John D Mellinger. 2003. Upper gastrointestinal endoscopy: current status.. https://doi.org/10.1177/107155170301000103

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Jejunogastric intussusception: a case report with the review of literature.

Jejunogastric intussusception (JGI) is a rare but potentially lethal complication of gastrectomy or gastrojejunostomy. In the acute setting, early diagnosis and prompt surgical intervention are mandatory to avoid mortality. We present a case of JGI in a patient with a history of gastrojejunostomy who had increasing vomiting, hematemesis, and abdominal pain for 1 day.

Endoscopy, Digestive System↗
PubMed2006

Wireless capsule endoscopy in the investigation of patients with chronic renal failure and obscure gastrointestinal bleeding (preliminary data).

AIM: To investigate the role of wireless capsule endoscopy (WCE) in detection of small bowel (SB) pathology in patients with chronic renal failure (CRF) and obscure bleeding. METHODS: Consecutive CRF patients with obscure bleeding were prospectively studied. Patients with normal renal function and obscure bleeding, investigated during the same period with WCE, were used for the interpretation of results. RESULTS: Seventeen CRF patients (11 overt, 6 occult bleeding) and 51 patients (33 overt, 18 occult bleeding) with normal renal function were enrolled in this study. Positive SB findings were detected in 70.6% of CRF patients and in 41.2% of non-CRF patients (P < 0.05). SB angiodysplasia was identified in 47% of CRF patients and in 17.6% of non-CRF patients. Univariate logistic regression revealed CRF as a significant predictive factor for angiodysplasia (P < 0.05). Therapeutic measures were undertaken in 66% of the patients with the positive findings. CONCLUSION: According to our preliminary results, SB angiodysplasia was found in an increased prevalence among CRF patients with obscure bleeding. WCE is useful in diagnosis of gastrointestinal pathologies and in planning appropriate therapeutic intervention and, therefore, should be included in the work-up of this group of patients.

Endoscopy, Digestive System↗
PubMed2006

Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease.

BACKGROUND: Approximately 25% of adults experience heartburn, the cardinal feature of gastro-oesophageal reflux disease (GORD), at least monthly. The evaluation and treatment of patients with suspected GORD is associated with a substantial economic burden. Most patients are treated empirically (without specific diagnostic evaluation). They include a wide range of underlying oesophageal injury. The severity of oesophageal injury can only be established in those who have undergone upper endoscopy. Patients without visible damage to the oesophagus have been referred to as having endoscopy negative reflux disease (ENRD). The pathogenesis of ENRD as well as its response to treatment may differ from GORD with oesophagitis. OBJECTIVES: Summarise, quantify and compare the efficacy of the short-term use of proton pump inhibitors (PPI), H2-receptor antagonists (H2RA) and prokinetics in adults with GORD, treated empirically and in those with endoscopy negative reflux disease (ENRD). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2005), MEDLINE (January 1966 to December 2005), EMBASE (January 1988 to December 2005). SELECTION CRITERIA: Randomised controlled trials focussing on symptomatic outcome after short-term treatment for GORD using proton pump inhibitors, H2-receptor antagonists or prokinetic agents. Studies were included provided that participants could be classified in the empirical treatment group (no endoscopy used in treatment allocation) or in the endoscopy negative reflux disease group (no endoscopic signs of erosive oesophagitis). DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Thirty-one trials (9457 participants) were included: fifteen in the empirical treatment group, twelve in the ENRD group and four in both. In empirical treatment of GORD the relative risk (RR) for heartburn remission (the primary efficacy variable) in placebo-controlled trials for PPI was 0.37 (two trials, 95% confidence interval (CI) 0.32 to 0.44), for H2RAs 0.77 (two trials, 95% CI 0.60 to 0.99) and for prokinetics 0.86 (one trial, 95% CI 0.73 to 1.01). In a direct comparison PPIs were more effective than H2RAs (seven trials, RR 0.66, 95% CI 0.60 to 0.73) and prokinetics (two trials, RR 0.53, 95% CI 0.32 to 0.87). In treatment of ENRD, the RR for heartburn remission for PPI versus placebo was 0.69 (seven trials, 95% CI 0.62 to 0.78) and for H2RA versus placebo was 0.84 (two trials, 95% CI 0.74 to 0.95). The RR for PPI versus H2RA was 0.78 (three trials, 95% CI 0.62 to 0.97) and for PPI versus prokinetic 0.72 (one trial, 95% CI 0.56 to 0.92). AUTHORS' CONCLUSIONS: PPIs are more effective than H2RAs in relieving heartburn in patients with GORD who are treated empirically and in those with ENRD, although the magnitude of benefit is greater for those treated empirically.

Endoscopy, Digestive System↗