Which Upper GI Findings During EGD Do Not Require Follow-Up?
Prateek Sharma, MD, FASGE, reviewing Rodríguez-de-Santiago E, et al. Endoscopy 2020 Apr 14.
The European Society of Gastrointestinal Endoscopy (ESGE) has issued recommendations on conditions that do not require routine surveillance. Those related to upper GI endoscopy include:
- Esophageal inlet patch (islands of heterotopic gastric mucosa in the proximal esophagus)
- Los Angeles Grade A or B erosive esophagitis
- Irregular Z line or columnar-lined esophagus <1 cm
- Intestinal metaplasia in the antrum without risk factors (known risk factors include persistent Helicobacter pylori infection, incomplete metaplasia, or a family history of gastric cancer)
- Fundic gland polyps without suspicious endoscopic features (ulceration, aberrant surface pattern, or hereditary syndromes)
- Asymptomatic subepithelial lesions (leiomyomas, lipomas, and antral pancreatic rests), regardless of their size
- Duodenal ulcer disease (unless persistently symptomatic despite adequate therapy with proton pump inhibitors, eradication of H pylori, and discontinuation of nonsteroidal anti-inflammatory drugs)
COMMENTWhile it is important to delineate gastrointestinal disease states and endoscopy findings that need regular and frequent surveillance, it is equally important for endoscopists to recognize conditions that do not require follow-up endoscopy. This is important to reduce the burden on health care resources and to avoid unnecessary risk associated with unwarranted procedures. The above-mentioned list includes several findings frequently encountered during upper endoscopies, including irregular Z lines, inlet patches, and lower grades of erosive esophagitis.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Rodríguez-de-Santiago E, Frazzoni L, Fuccio L, et al. Digestive findings that do not require endoscopic surveillance – reducing the burden of care: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy 2020 Apr 14. (Epub ahead of print) (https://doi.org/10.1055/a-1137-4721)
