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J R Soc Med. 1998 October; 91(10): 524–527.
PMCID: PMC1296910

The one-stop dyspepsia clinic--an alternative to open-access endoscopy for patients with dyspepsia.


The most sensitive investigative tool for the upper gastrointestinal tract is endoscopy, and many gastroenterologists offer an open-access endoscopy service to general practitioners. However, for patients with dyspepsia, endoscopy is not always the most appropriate initial investigation, and the one-stop dyspepsia clinic allows for different approaches. We have audited, over one year, the management and outcomes of patients attending a one-stop dyspepsia clinic. All patients seen in the clinic were included, and for those not endoscoped the notes were reviewed one year after the end of the study to check for reattendances and diagnoses originally missed. Patients' and general practitioners' views of the service were assessed by questionnaire. 485 patients were seen, of whom 301 (62%) were endoscoped at first attendance. In 66 patients (14%), endoscopy was deemed inappropriate and only one of these returned subsequently for endoscopy. 118 patients (24%) were symptom-free when seen in the clinic and were asked to telephone for an appointment if and when symptoms recurred; half of these returned and were endoscoped. Oesophagitis and duodenal ulcer were significantly more common in this 'telephone endoscopy' group than in those endoscoped straight from the clinic. Overall, 25% of patients referred were not endoscoped. Important additional diagnoses were made from the clinic consultation. General practitioners and patients valued the system, in particular the telephone endoscopy service. 84% of general practitioners said they would prefer the one-stop dyspepsia clinic to open-access endoscopy.

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Selected References

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  • Erwin J, Britten N, Jones R. General practitioners' views on the over-the-counter availability of H2-antagonists. Br J Gen Pract. 1997 Feb;47(415):99–102. [PMC free article] [PubMed]
  • Silcock JG, Bramble MG. Open access gastroscopy: second survey of current practice in the United Kingdom. Gut. 1997 Feb;40(2):192–195. [PMC free article] [PubMed]
  • Bramble MG. Open access endoscopy--a nationwide survey of current practice. Gut. 1992 Feb;33(2):282–285. [PMC free article] [PubMed]
  • Heatley RV. Open access upper gastrointestinal endoscopy. BMJ. 1993 May 8;306(6887):1224–1224. [PMC free article] [PubMed]
  • Axon AT, Bell GD, Jones RH, Quine MA, McCloy RF. Guidelines on appropriate indications for upper gastrointestinal endoscopy. Working Party of the Joint Committee of the Royal College of Physicians of London, Royal College of Surgeons of England, Royal College of Anaesthetists, Association of Surgeons, the British Society of Gastroenterology, and the Thoracic Society of Great Britain. BMJ. 1995 Apr 1;310(6983):853–856. [PMC free article] [PubMed]
  • Saunders BP, Trewby PN. Open access endoscopy: is the lost outpatient clinic of value? Postgrad Med J. 1993 Oct;69(816):787–790. [PMC free article] [PubMed]
  • Lobo A, Dickinson R. Managing the dyspeptic patient: experience of a single-visit dyspepsia clinic. J R Soc Med. 1988 Apr;81(4):212–213. [PMC free article] [PubMed]
  • Beavis AK, La Brooy S, Misiewicz JJ. Evaluation of one-visit endoscopic clinic for patients with dyspepsia. Br Med J. 1979 May 26;1(6175):1387–1389. [PMC free article] [PubMed]
  • Dickey W, Kenny BD, McConnell JB. Effect of proton pump inhibitors on the detection of Helicobacter pylori in gastric biopsies. Aliment Pharmacol Ther. 1996 Jun;10(3):289–293. [PubMed]
  • McColl KE, el-Nujumi A, Murray L, el-Omar E, Gillen D, Dickson A, Kelman A, Hilditch TE. The Helicobacter pylori breath test: a surrogate marker for peptic ulcer disease in dyspeptic patients. Gut. 1997 Mar;40(3):302–306. [PMC free article] [PubMed]
  • Bramble MG, Cooke WM, Corbett WA, Cann PA, Clarke D, Contractor B, Hungin AS. Organising unrestricted open access gastroscopy in South Tees. Gut. 1993 Mar;34(3):422–427. [PMC free article] [PubMed]
  • Neale G. Reducing risks in gastroenterological practice. Gut. 1998 Jan;42(1):139–142. [PMC free article] [PubMed]

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