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What are the recommended follow-up procedures after an OGD reveals esophagitis or gastric ulcers?
Answer
After an oesophagogastroduodenoscopy reveals oesophagitis, the recommended follow-up includes offering a full-dose proton pump inhibitor (PPI) for 8 weeks to heal severe oesophagitis, considering the person's preferences and clinical circumstances. If initial treatment fails, options include increasing the PPI dose, switching to another full-dose or high-dose PPI, and if severe oesophagitis persists despite maintenance treatment, a clinical review and possible specialist referral are advised.
For gastric ulcers, if Helicobacter pylori infection is present, eradication therapy should be offered. Repeat endoscopy is recommended 6 to 8 weeks after starting treatment to confirm healing, with the timing depending on the size of the lesion. Retesting for H. pylori is also advised 6 to 8 weeks after treatment. If the patient is negative for H. pylori and not taking NSAIDs, a full-dose PPI or H2 receptor antagonist therapy for 4 to 8 weeks is recommended. For patients continuing NSAIDs after ulcer healing, the potential harms should be discussed.
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