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The management of upper gastrointestinal symptoms: is endoscopy indicated?

Anne E Duggan
Med J Aust 2007; 186 (4): 166-167.
Published online: 19 February 2007

Testing for Helicobacter pylori, and acid-suppression therapy are nearly always better strategies

Most patients with upper gastrointestinal symptoms can be effectively managed without investigation. Recent long-term follow-up of patients with upper gastrointestinal symptoms shows that most have a benign course.1,2 A recent follow-up of 300 patients 9 years after investigations showed that 40% were asymptomatic; 70% of these without medication.2 Such a good outcome is the result of the decline of Helicobacter pylori3 (making peptic ulcer uncommon and gastric cancer rare in the absence of genetic or ethnic predisposition) and the easy availability of effective acid-suppression therapy (making gastro-oesophageal reflux disease easily treatable). For the vast majority of patients, upper gastrointestinal symptoms are now a dis-ease, not a disease.

  • Anne E Duggan

  • John Hunter Hospital, Newcastle, NSW.


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