patients with dyspesia in whom an OGD is appropriate

Last edited 03/2019

Review medications for possible causes of dyspepsia (for example, calcium antagonists, nitrates, theophyllines, bisphosphonates, corticosteroids and non-steroidal antiinflammatory drugs [NSAIDs]). In patients requiring referral, suspend NSAID use.

Suspected Oesophageal cancer

  • offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) to assess for oesophageal cancer n people:
    • with dysphagia or
    • aged 55 and over with weight loss and any of the following:
      • upper abdominal pain
      • reflux
      • dyspepsia

Suspected Stomach cancer

  • consider a suspected cancer pathway referral (for an appointment within 2 weeks) for people with an upper abdominal mass consistent with stomach cancer
  • offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) to assess for stomach cancer in people:
    • with dysphagia or
    • aged 55 and over with weight loss and any of the following:
      • upper abdominal pain
      • reflux
      • dyspepsia

Non Urgent Referral guidance:

Suspected stomach cancer/oesophageal cancer:

  • consider non-urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer/oesophageal cancer in people with haematemesis

  • consider non-urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer/oesophageal cancer in people aged 55 or over with:
    • treatment-resistant dyspepsia or

    • upper abdominal pain with low haemoglobin levels or

    • raised platelet count with any of the following:
      • nausea
      • vomiting
      • weight loss
      • reflux
      • dyspepsia
      • upper abdominal pain, or

    • nausea or vomiting with any of the following:
      • weight loss
      • reflux
      • dyspepsia
      • upper abdominal pain

Reference: