Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions

Publication Date: October 1, 2015
Last Updated: September 2, 2022

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

Overview

Title

Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions

Authoring Organization

Publication Month/Year

October 1, 2015

Last Updated Month/Year

December 1, 2022

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

Technical Review

Methodology

Number of Source Documents
177
Literature Search Start Date
October 1, 2013
Literature Search End Date
November 18, 2013