Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions
Publication Date: October 1, 2015
Summary of Recommendations from the AGA Guideline on Upper-GI Biopsies to Evaluate Adult Dyspepsia
Esophagus
In patients undergoing EGD for dyspepsia as the sole indication, the AGA recommends against obtaining routine biopsies of the normal-appearing esophagus or GE junction regardless of immune status. ( Very Low , Strong )
612
Stomach
In immunocompetent patients undergoing EGD for dyspepsia as the sole indication, the AGA recommends obtaining routine biopsies of the normal-appearing gastric body and antrum for the detection of HP infection if the HP infection status is unknown. ( Moderate , Strong )
612
In immunocompromised patients undergoing EGD for dyspepsia as the sole indication, the AGA recommends obtaining routine biopsies of the normal-appearing gastric body and antrum for the detection of HP infection if the HP infection status is unknown. ( Very Low , Strong )
612
When obtaining biopsies from the normal-appearing gastric body and antrum for the detection of HP infection, the AGA suggests following the 5-biopsy Sydney System with all specimens placed in the same jar. ( Moderate , Conditional (weak) )
612
When biopsies are obtained from the normal-appearing gastric body and antrum for the detection of HP infection, the AGA suggests NOT obtaining automatic special staining of the specimens. ( Moderate , Conditional (weak) )
612
Duodenum
In patients undergoing EGD for dyspepsia as the sole indication, and in the absence of signs or symptoms associated with an increased risk of celiac disease, the AGA suggests NOT obtaining routine biopsies of the normal-appearing duodenum to detect celiac disease. ( Very Low , Conditional (weak) )
612
In immunocompromised patients undergoing EGD for dyspepsia as the sole indication, the AGA suggests obtaining routine biopsies of the normal-appearing duodenum for the detection of GVHD in post-allogeneic tissue transplantation patients and for opportunistic infections. ( Very Low , Conditional (weak) )
612
When biopsies are obtained from the normal-appearing duodenum, the AGA suggests NOT performing routine special staining of the specimens. ( Very Low , Conditional (weak) )
612
Recommendation Grading
Disclaimer
Overview
Title
Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions
Authoring Organization
American Gastroenterological Association
Publication Month/Year
October 1, 2015
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
The purpose of the current guideline is to establish evidence-based practicing standards for the performance of biopsies ofnormal-appearing mucosa in the upper gastrointestinal tract
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis
Diseases/Conditions (MeSH)
D004415 - Dyspepsia
Keywords
dyspepsia, esophagogastroduodenoscopy (EGD), Esophagogastroduodenoscopy, upper gastrointestinal tract
Supplemental Methodology Resources
Methodology
Number of Source Documents
177
Literature Search Start Date
October 1, 2013
Literature Search End Date
November 18, 2013