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Old 04-06-2013
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GIT When to do Endoscopy

This is confused me so wanted to make sure if I have the concept down:

- If disease is causing mucosa changes - scope (Esophageal cancer)

- Barium swallow (Achalasia, DES/Nutcracker, Webs, Rings, Zenkers) - do this as best initial Dx test. Confirmation with scope or manometry (avoid scope in Zenkers)

- You should scope 1st if <45yoa if they have weight-loss accompanied by animea, or blood in stool and/or no response to Tx, recurrence, excessive voimiting.... weight-loss alone does not warrant scope

- >45 you can scope especial if you suspect cancer, no response to Tx, recurrence, excessive vomiting...
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Old 04-06-2013
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Sorry forgot to add that:

Obstruction also warrants endoscopy as best initial test.
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Old 04-07-2013
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you got it right dude
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  #4  
Old 04-07-2013
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Also forgot mention when pt is <45 yoa with just epigastric pain then just do treatment with H2 blocker or liquid ant-acids, if symptoms bad give PPI.
If symptoms still present even with tx then scope.

If same pt above just has epigastric pain but without anemia, weight-loss, heme positive stool, dysphagia, etc... scope 1st then treat
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