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Upper gastrointestinal endoscopy

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of upper gastrointestinal endoscopy are prepared by our editorial team based on guidelines from the American College of Gastroenterology (ACG/CAG 2022), the European Society of Gastrointestinal Endoscopy (ESGE 2021), the European Society of Gastrointestinal Endoscopy (ESGE/BSG 2021), and the American Society for Gastrointestinal Endoscopy (ASGE 2020,2018,2016). ...
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Diagnostic procedures

Tissue sampling, technical considerations: as per ESGE 2021 guidelines, consider placing mucosal biopsy specimens into labeled containers containing adequate amounts of tissue fixation fluid (10% buffered formalin).
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  • Tissue sampling (dyspepsia and GERD)

  • Tissue sampling (Barrett's esophagus)

  • Tissue sampling (premalignant and malignant lesions)

  • Tissue sampling (celiac disease)

  • Tissue sampling (eosinophilic esophagitis)

  • Tissue sampling (infectious esophagitis)

Medical management

Management of antiplatelet therapy, preprocedural: as per ACG/CAG 2022 guidelines, insufficient evidence to recommend for or against temporary interruption of the P2Y12 inhibitor in patients on single antiplatelet therapy with P2Y12 inhibitor agents undergoing elective endoscopic gastrointestinal procedures.
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  • Management of antiplatelet therapy (postprocedural)

  • Management of antiplatelet therapy (acute gastrointestinal bleeding)

  • Management of anticoagulant therapy (preprocedural)

  • Management of anticoagulant therapy (postprocedural)

  • Management of anticoagulant therapy (acute gastrointestinal bleeding)

Quality improvement

Requirements for staffing members: as per ASGE 2020 guidelines, consider ensuring a minimum staffing of 1 endoscopy staff member (unlicensed assistive personnel or registered nurse) in the room for routine procedures without sedation.
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  • Requirements for infection control