Too many upper endoscopies are being done unnecessarily, so if you have heartburn (GERD), take notice of this information.

If you’ve been diagnosed with heartburn secondary to GERD, but you have not had an upper endoscopy, have you ever wondered if you need this procedure?

A person may also find themselves tinkering with the idea of an upper endoscopy after learning that years of heartburn can lead to precancerous changes in the esophagus (Barrett’s esophagus).

“GERD or gastroesophageal reflux disease is a very common condition, with heartburn being the most common symptom of GERD — and seen in up to 50% people with GERD,” says Alan Gingold, DO, a board certified gastroenterologist with the Digestive Healthcare Center of NJ.

“Not everyone with heartburn needs to get an upper endoscopy,” continues Dr. Gingold.

“Typically an EGD is recommended for anyone who has heartburn that is longstanding (more than five years), symptoms not responding to medication, anyone aged 45 or over who has new symptoms or anyone with alarm symptoms: nausea/vomiting, dysphagia, anemia, blood on stool, weight loss.”

Dysphagia is difficulty swallowing.

Nevertheless, there may still be too many unnecessary endoscopies being done. In 2012, the Annals of Internal Medicine reported this.

Though that was years ago, it’s quite possible that people with heartburn are continuing to get unneeded upper endoscopies.

  • After all, ads for heartburn relief continue to regularly air on TV and appear in print media.
  • Furthermore, Barrett’s esophagus has received increased publicity.

However, if you seem to have heartburn or even if you were recently diagnosed with this condition, the next step is NOT to gun for the upper endoscopy.

Other Reasons for an Upper Endoscopy

If one’s heartburn doesn’t respond to medication after 4-8 weeks, this may call for an upper endoscopy.

Another reason for this exam is if the patient’s esophagus has a history of tightening or narrowing.

If the patient is over 50, male, has had diagnosed heartburn for at least five years, AND has other risk factors for Barrett’s esophagus – then he’s a candidate for an upper endoscopy.

Other Risk Factors for Barrett’s Esophagus

  • Overnight reflux symptoms
  • Excess body fat, especially in the belly
  • Hiatal hernia
  • Tobacco use

This patient may undergo an initial screening test for Barrett’s esophagus or esophageal cancer. If the result is negative, then periodic upper endoscopy is not needed.

What if you have Barrett’s esophagus?

Upper endoscopy should be done every three to five years.

If the patient has dysplasia, the upper endoscopy should be more frequent.

Overuse of upper endoscopy has not been found to improve the health or survival of patients suffering from heartburn.

Dr. Gingold attributes his success to the extra time he spends with his patients. His areas of expertise include reflux disease, Barrett’s esophagus, capsule endoscopy, chronic liver disease and inflammatory bowel disease.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
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