This is a summary of the referral criteria for upper GI endoscopy outlined in NICE clinical guidelines.
Significant acute GI bleeding.
Urgent referral (within 2 weeks)
1. Patients of any age with dyspepsia who present with any of the following should have an urgent referral for endoscopy or referral to a specialist in upper gastrointestinal cancer:
- chronic gastrointestinal bleeding
- progressive dysphagia
- progressive unintentional weight loss
- persistent vomiting
- iron deficiency anaemia
- epigastric mass
- suspicious barium meal result.
2. Patients aged 55 years and older with unexplained and persistent recent-onset dyspepsia.
3. Patients presenting with the following, even in the absence of dyspepsia, should have an urgent referral for endoscopy or referral to a specialist in upper gastrointestinal cancer:
- unexplained upper abdominal pain and weight loss, with or without back pain
- upper abdominal mass
- obstructive jaundice (depending on clinical state).
and consider urgent referral for:
- persistent vomiting and weight loss in the absence of dyspepsia
- unexplained weight loss
- iron deficiency anaemia.
4. Consider urgent referral for patients with unexplained worsening of their dyspepsia who are known to have any of the following risk factors:
- Barrett's oesophagus
- atrophic gastritis (pernicious anaemia)
- intestinal metaplasia
- peptic ulcer surgery more than 20 years ago.
British Society of Gastroenterology recommendations and expert advice suggest non-urgent referral for:
- patients with liver disease, to detect oesophageal varices
- patients who have resistant H.pylori infection with worsening of dyspepsia
- post-treatment (6 to 8 weeks) endoscopy for gastric ulcer and bleeding duodenal ulcer
- coeliac disease, for confirmatory biopsy
- Barrett's oesophagus surveillance
- follow-up of oesophageal ulcer (8 weeks).
(See reference documents at BSG website - Guidelines for the diagnosis and management of Barrett´s columnar-lined oesophagus and Guidelines for the management of patients with coeliac disease.
This page was last updated: 22 November 2007