title: Gastrointestinal endoscopy: an accurate and safe primary diagnostic and therapeutic modality.
abstract: OBJECTIVE
  To review the place of gastrointestinal endoscopy in the management of upper and lower gastrointestinal disorders.
  
  
  METHODS
  We reviewed articles on endoscopy reported over two decades. A Medline search complementing our experience and knowledge of the literature was used to identify the articles.
  
  
  METHODS
  Papers were selected which focused on indications, comparison with radiology, including clinical outcome measures, and complications. One hundred papers, including those from radiology journals, were reviewed.
  
  
  METHODS
  Results of studies are referenced as appropriate.
  
  
  CONCLUSIONS
  Endoscopy allows direct visualisation of the mucosa of the upper gastrointestinal tract, colon and terminal ileum. Subtleties of colour change, vascular pattern abnormalities and scarring are easily detected at endoscopy and are often of diagnostic importance. Endoscopy also provides access for tissue biopsy and allows a wide variety of therapeutic interventions. Traditionally barium studies have been the first step in the evaluation of many gastrointestinal symptoms and still retain cost advantages over endoscopy. However, endoscopy is frequently more sensitive and specific than barium studies. Costs associated with incorrect diagnoses may undermine the apparent cost benefits of barium studies. Advances in endoscopic design have allowed wider therapeutic options and increased safety. Gastrointestinal endoscopy should now be the first line of investigation where diagnostic precision is required or where therapeutic intervention is likely.
authors.affiliation: Department of Gastroenterology, Royal Brisbane Hospital, Herston, Qld.
authors.forename: A E
authors.initials: AE
authors.lastname: Cowen
authors.forename: F A
authors.initials: FA
authors.lastname: Macrae
mesh_terms: D001466:Barium Sulfate; D001706:Biopsy / Q000379:methods; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy; D003365:Costs and Cost Analysis; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000191:economics; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D012680:Sensitivity and Specificity
chemical_list: D001466:Barium Sulfate