Gastroscopy

High yield indications :

Acute upper GI bleeding, to establish the exact location of hemorrhage prior to endoscopic cautery, surgery, etc.

Dysphagia, especially if esophageal strictures or ulcerations are seen on a previous upper gastro intestinal series.

Dyspepsia, if refractory to standard medical antireflux therapy. EGD is also indicated whenever a surgical antireflux procedure is planned.

Odynophagia, when inflammation or infection is clinically suspected, especially if esophagitis from Candida, cytomegalovirus, or herpes simplex virus is likely.

Surveillance endoscopy for known pre-malignant conditions, such as Barrett's esophagus, lye-induced strictures, Plummer-Vinson syndrome.

Abnormalities seen on upper GI series which require visual confirmation and tissue biopsy (eg, polyps, gastric ulcers, redundant gastric folds, strictures)

Suspected gastric outlet obstruction.

Lower yield indications :

Atypical chest pain.

Abdominal pain of unknown etiology.

Routine, uncomplicated cases of gastroesophageal reflux.

Uncomplicated cases of duodenal ulcer demonstrated by upper GI series.