This is one of a series of statements discussing the utilization of GI endoscopy, in common clinical situations. The Standards of Practice Committee of the American Society, for Gastrointestinal Endoscopy, prepared this text. In preparing Ibis guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy, are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify, aspects of Ibis statement, and revision may, be necessary, as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.