Same-Day Upper and Lower Inpatient Endoscopy: A Trend for the Future

Performance of same-day upper and lower endoscopy has many potential advantages, as it may reduce costs, shorten hospital stay, and expedite patient care, but its feasibility, efficacy, and potential have not been carefully defined. We report here our experience with a group of 87 patients who underwent same-day upper and lower endoscopy (174 procedures) over a 2-yr period at a tertiary care VA Hospital, compared with an alternate-day upper and lower endoscopy group of 50 patients (100 procedures) over the same time period. Most patients were elderly males. Common indications for endoscopy were occult or overt gastrointestinal bleeding, previous or concomitant history of pertinent pathology (i.e., polyps, ulcers), abdominal pain, diarrhea, or other symptoms, abnormal radiological studies, and iron deficiency anemia. Both groups required similar amounts of intravenous sedation. There were no complications in either group. In both groups, common positive findings were inflammation (i.e., colitis, esophagitis), benign neoplasms, diverticulae, peptic ulcer, and cancer. In both groups, only 2-6% had negative upper and lower endoscopy, whereas either one procedure was negative in 25% and 18% of cases, respectively. We conclude that the practice of same-day inpatient upper and lower endoscopy is feasible, has excellent diagnostic yield, even in the elderly, and carries no increased risks. When indicated, the practice of same-day upper and lower endoscopy should be encouraged.