ACP77 GERD guidelines
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Slate 1
American College of Physicians: Upper Endoscopy is Overused in Patients with Heartburn
New Evidence-Based Paper in Annals of Internal Medicine
Aims to Inform Patients and Physicians about Current and Effective Standards of Care
Video News Story from American College of Physicians
American College of Physicians
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Slate 2
Courtesy the American College of Physicians,
publisher of Annals of Internal Medicine.
Slate 3
Table of Contents:
Story Description
Interview ID
Suggested Lead
Full Video Package
:30 Video Package
Additional Soundbites
Additional B-Roll
ACP77 GERD guidelines
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Slate 4
Story Description: Heartburn is one of the primary symptoms of gastroesophageal reflux
disease, or GERD, and is one of the most common reasons people see a doctor. More than 113
million prescriptions are filled to treat GERD each year costing $14 billion dollars—making it the
third largest selling drug category in the world. Upper endoscopy is routinely performed for the
diagnosis and management of the condition but may not be necessary according to the
American College of Physicians (ACP).
An evidence-based paper published in Annals of Internal Medicine finds that upper endoscopy
is not needed for most patients unless other serious symptoms are present. The ACP says that
inappropriate use of upper endoscopy does not improve the health of patients, exposes them to
preventable harms, may lead to unnecessary interventions, and result in unnecessary costs with
no benefit.
The ACP finds that medication to reduce gastric acid production is warranted in most patients
with typical GERD symptoms. Upper endoscopy is appropriate in patients with heartburn who
are unresponsive to medicine to reduce gastric acid production. The ACP does recommend
endoscopy when serious symptoms are present, such as difficult or painful swallowing,
bleeding, anemia, weight loss, or recurrent vomiting.
For men over the age of 50 with multiple risk factors, screening with upper endoscopy may be
needed for Barrett's esophagus, a disorder in which the lining of the esophagus is damaged by
stomach acid and may lead to cancer.
The recommendations are part of ACP’s High Value Care initiative and aim to inform patients
and doctors about current and effective standards of care. As with all tests and treatments,
people with heartburn should talk to their doctor about upper endoscopy so that they understand
the benefits and risks of the procedure.
Slate 5
Interview Id
David Bronson, MD, FACP
President
American College of Physicians
Slate 6
Suggested Lead: Heartburn is one of the most common reasons people visit their doctor and
we spend $14 billion dollars annually on medications to treat it. Yet one of the nation's leading
medical organizations says one procedure is being overused.
Slate 7
ACP77 GERD guidelines
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Full Video Package:
(1) Announcer: Upper endoscopy is commonly
used in the diagnosis and management of
gastroesophageal reflux disease or GERD for
patients with heartburn--one of the most common
reasons people see a doctor. But the American
College of Physicians says that the procedure is
being overused for most patients.
David Bronson, MD FACP
President
American College of Physicians
(2) David Bronson: The American College of
Physicians recommends that upper endoscopy be
reserved for patients who fail therapy or have
other symptoms suggestive of a more serious
disease.
(3) Announcer: The new evidence-based
recommendations are published in Annals of
Internal Medicine. The ACP says that
inappropriate use of upper endoscopy does not
improve the health of patients, exposes them to
preventable harms, may lead to unnecessary
interventions, and result in unnecessary costs with
no benefit.
(4) David Bronson: Patients with heartburn
usually do not require upper endoscopy as the
first part of their evaluation unless they have
symptoms such as weight loss, bleeding, repeated
vomiting, or difficulty with foods.
(5) Announcer: The recommendations are part of
ACP’s High Value Care initiative and aim to inform
patients and doctors about current and effective
standards of care. The recommendations say that
medicine to reduce gastric acid production is
warranted in most patients with typical GERD
symptoms such as heartburn or regurgitation.
(6) David Bronson: Upper endoscopy is usually
appropriate in those circumstances where you
have symptoms such as vomiting, weight loss,
pain with swallowing, or food sticking, or bleeding.
Additionally, patients who fail to respond to
treatment after an appropriate period of time
should have an endoscopy.
ACP77 GERD guidelines
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(7) Announcer: For men over the age of 50 with
multiple risk factors, screening with upper
endoscopy may be needed for Barrett's
esophagus, a disorder in which the lining of the
esophagus is damaged by stomach acid and may
lead to cancer.
(8) David Bronson: I think it’s very important that
patients have a conversation with their doctor
about lifestyle factors that may be playing a role
so they can be corrected.
(9) Announcer: For more information go to
acponline.org
Slate 8
:30 Version
(1) Announcer: Upper endoscopy is commonly
used in the diagnosis and management of
gastroesophageal reflux disease or GERD for
patients with heartburn--one of the most common
reasons people see a doctor. But the American
College of Physicians says that the procedure is
being overused for most patients.
Dr. David Bronson, MD FACP
President
American College of Physicians
(2) David Bronson: The American College of
Physicians recommends that upper endoscopy be
reserved for patients who fail therapy or have
other symptoms suggestive of a more serious
disease.
(3) Announcer: For more information go to
acponline.org
Slate 9
B-roll Bites:
David Bronson, MD FACP
President
American College of Physicians
ACP77 GERD guidelines
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The most appropriate first step is not endoscopy in most cases, unless there are symptoms of
concern that the doctor picks up during an evaluation. The most appropriate first treatment is an
acid sup-, a trial of acid suppression
For most patients with, heartburn, or GERD, upper endoscopy is not necessary as an initial first
step. Usually treatment with a acid inhibitor is sufficient to control symptoms.
Patients with heartburn usually do not require upper endoscopy as the first part of their
evaluation unless they have symptoms such as weight loss, bleeding, repeated vomiting, or
difficulty with foods going down, getting stuck, or severe pain.
For my patients, I recommend very much that they be clear about their history and get a nice
understanding of what factors often precipitate heartburn, sometimes as alcohol, sometimes it’s
just excessive coffee, sometimes it’s medicines for arthritis.
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Additional B-roll
Slate 11
Courtesy the American College of Physicians,
publisher of Annals of Internal Medicine