A “network meta-analysis” (we’ll explain that) finds that “test and treat” is the best way forward in managing this common condition.

Patients, paradoxically, prefer immediate endoscopy to test-and-treat, but unless the patient has “alarm symptoms” (such as dysphagia, weight loss, and anemia), endoscopy is likely to add complications and costs without adding further benefit.

Our guest is Prof. Alexander Ford of Leeds, senior author on the guideline-affirming study in The BMJ.

Links:

Article in The BMJ

Physician’s First Watch summary

NEJM Journal Watch Gastroenterology summary of 2017 joint U.S. – Canadian guideline