Upper Gastrointestinal Endoscopy off Proton Pump Inhibitor With Concurrent Telemetry Capsule pH Monitoring: Evidence Based and Cost Effective

In this current issue of Clinical Gastroenterology and Hepatology, Shah et  al1 present a carefully designed decision analytic model to assess costs and predefined health outcomes of 4 evaluation/management strategies in a patient presenting to a general gastroenterologist’s office with classic heartburn without alarm symptoms who failed a single empiric proton pump inh ibitor (PPI) trial. The authors modeled optimizing PPI without any further testing, upper gastrointestinal endoscopy (EGD) followed by continued optimized PPI if no erosions were found, EGD followed by discontinuing PPI if no erosions, and EGD plus ambulatory telemetry capsule reflux monitoring (pH) followed by PPI stoppage based on phenotype determined by EGD and pH findings.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Editorial Source Type: research