Upper endoscopy for GERD and GI symptoms

Status: Decision completed

Policy context

Upper GI symptoms, acid reflux and GERD are very common conditions. Upper endoscopy is an invasive diagnostic procedure that may be indicated for persons with upper GI symptoms and/or a diagnosis of GERD.

Primary criteria ranking

  • Safety = Low
  • Efficacy = Medium-High
  • Cost = Medium-High



Assessment timeline 

  • Draft report published: March 22, 2012
  • Public comment period: March 22 to April 5, 2012
  • Final report published: April 16, 2012
  • HTCC public meeting: May 18, 2012
  • Draft findings and decision published: June 27, 2012
  • Public comment period: June 27 to July 11, 2012


Upper endoscopy for gastroesophageal reflux disease (GERD) was selected for review by the HTA program. Acid reflux is a condition where the acidic juices (digestive acids) regurgitate or reflux up into the esophagus. GERD is a more serious form of acid reflux. Occasional acid reflux is a common condition and does not necessarily mean a person has GERD. GERD can lead to more serious health problems due to the effect of digestive acid on the lining of the esophagus. Causes of GERD are varied, but may include anatomical abnormalities, obesity, pregnancy, and smoking. GERD may occur in children and adults. Persistent acid reflux may indicate GERD.

Upper endoscopy is a diagnostic procedure. Upper endoscopy involves the insertion of a thin flexible tube down a patient's throat and esophagus. The endoscope has a light and camera attached allowing a doctor to visually inspect the esophagus for abnormalities and to take small pieces of tissue (biopsy) if needed.