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
Title
Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions
Authoring Organization
American Gastroenterological Association
Publication Month/Year
October 1, 2015
Last Updated Month/Year
November 6, 2024
External Publication Status
Published
Country of Publication
US
Document Objectives
This document presents the official recommendations of the American Gastroenterological Association (AGA) on the role of upper gastrointestinal biopsy to evaluate dyspepsia in the absence of mucosal lesions.
Target Patient Population
Adult patients with dyspepsia
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Diagnosis, Assessment and screening
Diseases/Conditions (MeSH)
D004415 - Dyspepsia
Keywords
dyspepsia, esophagogastroduodenoscopy (EGD), Esophagogastroduodenoscopy, upper gastrointestinal tract
Source Citation
Yang YX, Brill J, Krishnan P, Leontiadis G. American Gastroenterological Association Clinical Practice Guidelines Committee. American Gastroenterological Association Institute Guideline on the Role of Upper Gastrointestinal Biopsy to Evaluate Dyspepsia in the Adult Patient in the Absence of Visible Mucosal Lesions. Gastroenterology. 2015;149(4):1082-7.
Methodology
Number of Source Documents
177
Literature Search Start Date
October 1, 2013
Literature Search End Date
November 18, 2013