SOURCE: American College of Physicians

American College of Physicians

December 03, 2012 19:00 ET

American College of Physicians: Upper Endoscopy Is Overused in Patients With Heartburn

New Evidence-Based Paper in Annals of Internal Medicine Aims to Inform Patients and Physicians About Current and Effective Standards of Care

PHILADELPHIA, PA--(Marketwire - Dec 3, 2012) -  Heartburn is one of the primary symptoms of gastroesophageal reflux disease, or GERD, and is one of the most common reasons people see a doctor. More than 113 million prescriptions are filled to treat GERD each year costing $14 billion dollars -- making it the third largest selling drug category in the world. Upper endoscopy is routinely performed for the diagnosis and management of the condition but may not be necessary according to the American College of Physicians (ACP).

In an evidence-based paper published in Annals of Internal Medicine, the ACP finds that upper endoscopy is not needed for most patients unless other serious symptoms are present. The ACP says that inappropriate use of upper endoscopy does not improve the health of patients, exposes them to preventable harms, may lead to unnecessary interventions, and results in unnecessary costs with no benefit.

The ACP finds that medication to reduce gastric acid production is warranted in most patients with typical GERD symptoms. Upper endoscopy is appropriate in patients with heartburn who are unresponsive to medicine to reduce gastric acid production. The ACP does recommend endoscopy when serious symptoms are present, such as difficult or painful swallowing, bleeding, anemia, weight loss, or recurrent vomiting.

For men over the age of 50 with multiple risk factors, screening with upper endoscopy may be needed for Barrett's esophagus, a disorder in which the lining of the esophagus is damaged by stomach acid and may lead to cancer.

The recommendations are part of ACP's High Value Care initiative and aim to inform patients and doctors about current and effective standards of care. As with all tests and treatments, people with heartburn should talk to their doctor about upper endoscopy so that they understand the benefits and risks of the procedure.

About the American College of Physicians
The American College of Physicians ( is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 133,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter ( and Facebook (

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