Edinburgh Gastric Ulcer Score (EGUS)
Assesses the risk of malignancy in gastric ulcers and the need for repeat EGD/OGD.
Advice
- Macroscopic concerns or persistent/"red flag" symptoms override the results of this score; repeat upper endoscopy if the ulcer looks worrisome or symptoms continue.
- Any positive histology mandates further malignancy work-up, regardless of the EGUS result.
- All patients should receive appropriate acid suppression therapy and, when indicated, H. pylori eradication.
Management
- Low risk (score 0–2):
- Confirm ≥6 benign biopsies and symptom resolution.
- Repeat upper endoscopy may be avoided; reassure the patient but advise return if alarm symptoms arise.
- High risk (score ≥3): Arrange repeat upper endoscopy in 6–8 weeks (or sooner if symptoms persist) to confirm healing and obtain additional biopsies.
