ACR Updates Appropriateness Criteria for Epigastric Pain Imaging

ACR Appropriateness Criteria for epigastric pain updated: evidence-based imaging recommendations now cover esophageal/gastroduodenal perforation, GERD, esophagitis, peptic ulcer disease, hiatal hernia, and post-reflux surgery scenarios, using GRADE methodology.

• Guideline covers multiple clinical variants including acute perforation, GERD, esophagitis, gastritis, peptic ulcer disease, hiatal hernia, and recurrent symptoms after reflux surgery or procedures.
• Developed using GRADE methodology and RAND/UCLA Appropriateness Method; reviewed annually by a multidisciplinary expert panel synthesizing peer-reviewed literature.
• Where peer-reviewed evidence is lacking or equivocal, expert consensus serves as the primary evidentiary source — a recognized limitation of appropriateness criteria frameworks.

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