The management of upper gastrointestinal symptoms: is endoscopy indicated?

Anne E Duggan
Med J Aust 2007; 186 (4): . || doi: 10.5694/j.1326-5377.2007.tb00854.x
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.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.