title: Office-based ultrathin esophagogastroduodenoscopy in a primary care setting.
abstract: BACKGROUND
  Upper gastrointestinal complaints are common in primary care. These patients are often referred for evaluation with the use of esophagogastroduodenoscopy. This study examines the feasibility and safety of office-based ultrathin (diameter, 5.9 mm) esophagogastroduodenoscopy (u-EGD) without conscious sedation in a primary care setting.
  
  
  METHODS
  This study is a retrospective chart review in a university-based family medicine residency in the southeastern United States. Charts were reviewed for adult outpatients (N = 126) who were referred for further evaluation of heartburn, dyspepsia, or epigastric pain and who elected to undergo u-EGD procedure. We examined the number of patients willing to undergo office-based u-EGD, patient demographics, procedure indications and findings, patient request for oral benzodiazepines, and procedure and recovery times.
  
  
  RESULTS
  Of the 132 patients asked to participate in office-based u-EGD, 126 (95.4%) were willing to undergo this procedure (mean age, 47.6 +/- 1.3; 75% women). Of 126 patients, 122 (96.8%) tolerated office-based u-EGD, and 80.6% of patients requested oral anxiolytic medications. Significantly more women than men requested oral anxiolytic medications (84.0% versus 65.6%, respectively; P = .026). The retroflexion maneuver was completed in 120 of 122 (98.4%) patients, and the second portion of duodenum was reached in 122 of 122 (100%) patients. Mean procedure time was 16.9 +/- 0.7 minutes, and mean recovery time was 3.8 +/- 0.2 minutes. There were no complications reported in this case series.
  
  
  CONCLUSIONS
  The majority of patients can tolerate office-based u-EGD without conscious sedation in a primary care setting, but most patients request oral anxiolytic medications. Statistically more women request oral anxiolytic medications than do men.
authors.affiliation: Department of Family Medicine, Medical College of Georgia, Augusta 30912, USA. twilkins@mail.mcg.edu
authors.forename: Thad
authors.initials: T
authors.lastname: Wilkins
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Gillies
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D016145:Endoscopy, Digestive System / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011320:Primary Health Care; D012189:Retrospective Studies