Summary of Recommendations from the AGA Guideline on
Upper-GI Biopsies to Evaluate Adult Dyspepsia
Anatomic
location Statement
Strength of
recommendation
Quality of
evidence
Esophagus
In patients undergoing EGD for
dyspepsia as the sole indication, the
AGA recommends against obtaining
routine biopsies of the normal-
appearing esophagus or GE junction
regardless of immune status.
Strong Very low
Stomach
In immunocompetent patients
undergoing EGD for dyspepsia
as the sole indication, the AGA
recommends obtaining routine
biopsies of the normal-appearing
gastric body and antrum for the
detection of HP infection if the HP
infection status is unknown.
Strong Moderate
In immunocompromised patients
undergoing EGD for dyspepsia
as the sole indication, the AGA
recommends obtaining routine
biopsies of the normal-appearing
gastric body and antrum for the
detection of HP infection if the HP
infection status is unknown.
Strong Very low
When obtaining biopsies from
the normal-appearing gastric body
and antrum for the detection of
HP infection, the AGA suggests
following the 5-biopsy Sydney System
with all specimens placed in the same
jar.
Conditional Moderate
When biopsies are obtained from
the normal-appearing gastric body
and antrum for the detection of HP
infection, the AGA suggests NOT
obtaining automatic special staining
of the specimens.
Conditional Moderate
Diagnosis
