The role of endoscopy in dyspepsia

Commentary

In practice, dyspepsia is commonly used as an indication for endoscopy to exclude upper-gut mucosal abnormalities. However, in this review, Dr Nicholas J. Talley offers a much more pragmatic approach for the diagnosis and management of dyspepsia. By using several systematic reviews, meta-analyses, and recently proposed practice guidelines for dyspepsia, Dr Talley provides a convincing argument that upper endoscopy in subjects younger than 55 years with dyspepsia but without alarm symptoms is a low-yield diagnostic strategy. In contrast, subjects with dyspepsia and who are older than 55 years and/or with alarm symptoms would benefit from upper endoscopy as the initial evaluative strategy. An easy-to-follow (and remember) diagnostic algorithm for uninvestigated dyspepsia is offered at the end of the monograph.

– Ronnie Fass, MD, Editor