How heartburn drives unnecessary GI procedures

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Millions of Americans with uncomplicated heartburn continue to undergo unnecessary upper endoscopies. 

Motive Medical Intelligence — a healthcare analytics company focused on reducing low-value care — studied more than 100 million insurance claims from July 2022 through June 2024 and found 11% of gastroesophageal reflux disease visits included an esophagogastroduodenoscopy, despite longstanding guidance advising against routine use, according to a Nov. 12 news release.

National gastroenterology societies recommend EGD only for patients with alarm symptoms such as dysphagia, bleeding or unexplained weight loss.

The report also revealed sharp regional variation in adherence to these standards. Maine led the nation in guideline-based care, with just 4% of GERD visits involving unnecessary endoscopy. Rates were higher in the West and Southeast, with Wyoming, Iowa and Alaska showing the greatest overuse.

GERD affects about 20% of U.S. adults and drives more than $24 billion in annual healthcare spending, much of it tied to diagnostic overuse.

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