Recommendations were graded on the strength of the supporting evidence (Grades 1A--3). Definitions of the recommendation grades are presented at the end of the "Major Recommendations" field.

Summary

• Patients with dyspepsia who are older than 50 years of age and/or those with alarm features should undergo endoscopic evaluation. (1C)
• Patients with dyspepsia who are younger than 50 years of age and without alarm features may undergo an initial test-and-treat approach for Helicobacter pylori (H pylori). (1B)
• Patients who are younger than 50 years of age and are H pylori negative can be offered an initial endoscopy or a short trial of proton-pump inhibitors (PPI) acid suppression. (2B)
• Patients with dyspepsia who do not respond to empiric PPI therapy or have recurrent symptoms after an adequate trial should undergo endoscopy. (3)

Definitions:

Grades of Recommendation*

*Adapted from Guyatt G, Sinclair J, Cook D, Jaeschke R, Schunemann H, Pauker S. Moving from evidence to action: grading recommendations—a qualitative approach. In: Guyatt G, Rennie D, eds. Users' guides to the medical literature. Chicago: AMA Press; 2002. p. 599-608.

A clinical algorithm is provided in the original guideline document for evaluation of dyspepsia.

The type of supporting evidence is identified for each recommendation (see "Major Recommendations").

Not applicable: The guideline was not adapted from another source.

2001 Dec (revised 2007 Jan)

American Society for Gastrointestinal Endoscopy - Medical Specialty Society

American Society for Gastrointestinal Endoscopy

Standards of Practice Committee

Committee Members: Steven O. Ikenberry, MD; M. Edwyn Harrison, MD; David Lichtenstein, MD; Jason A. Dominitz, MD, MHS; Michelle A. Anderson, MD; Sanjay B. Jagannath, MD; Subhas Banerjee, MD; Brooks D. Cash, MD; Robert D. Fanelli, MD, SAGES Representative; Seng-Ian Gan, MD; Bo Shen, MD; Trina Van Guilder, RN, SGNA Representative; Kenneth K. Lee, MD, NAPSGHAN Representative; Todd H. Baron, MD, Chair

Not stated

None available

None available

This NGC summary was completed by ECRI on March 23, 2005. The information was verified by the guideline developer on March 31, 2005. This NGC summary was updated by ECRI Institute on March 4, 2008.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.