Navigation Links
ASGE issues guidelines on the role of endoscopy in the bariatric surgery patient

OAK BROOK, Ill. July 25, 2008 The American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines on the role of endoscopy in the bariatric surgery patient. The rising prevalence of obesity in the United States and the success in surgical interventions led to a marked increase in the number of weight-loss surgeries performed in the U.S., from 13,365 in 1998 to 102,794 in 2003. The guidelines discuss endoscopy in the preoperative patient and the postoperative patient, and appear in the July issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the ASGE.

Endoscopy is a procedure that uses an endoscope, a thin, flexible tube with a light and a lens on the end to look into the esophagus, stomach, duodenum, small intestine, colon, or rectum, in order to diagnose or treat a condition. There are many types of endoscopy, including colonoscopy, sigmoidoscopy, gastroscopy, enteroscopy, and esophogogastroduodenoscopy (EGD). ASGE is known as the profession's leader in setting standards of excellence in endoscopy and is committed to setting the highest-quality standards for GI endoscopy through its safety guidelines and the training of its members so that patients receive the best and safest care possible. The guideline, "Role of Endoscopy in the Bariatric Surgery Patient," was prepared by the ASGE Standards of Practice Committee.

"Obesity in this country is a major health problem that contributes to increased morbidity, mortality and a host of diseases. Bariatric surgery results in durable and significant weight loss," said Jason A. Dominitz, MD, MHS, chair of ASGE's Standards of Practice Committee. "Endoscopy plays an important role in the preoperative bariatric patient to detect and/or treat lesions in the gastrointestinal tract that might potentially affect the type of surgery performed. In addition, endoscopy is used to diagnose and treat many of the postoperative symptoms or conditions the patient may develop."

The role of upper endoscopy in the preoperative evaluation of patients undergoing bariatric surgery may be based, in part, on the presence or absence of symptoms. The rationale for performing an EGD is to identify and treat lesions that affect the type of surgery performed, cause complications in the immediate postoperative period, or result in symptoms after surgery.

When an endoscopy is considered in a patient who has had bariatric surgery, the endoscopist should be aware of the operative procedure performed, the findings on preprocedural imaging studies and they must understand the expected anatomy. The guidelines advise direct communication with the surgeon if possible. Endoscopy in the postoperative patient may be used to evaluate and treat a variety of conditions including: symptoms of nausea, vomiting and abdominal pain; marginal ulcers; gastroesophageal reflux disease (GERD); gastric leaks and gastrogastric fistulas; stenosis (abnormal narrowing of the stomach or intestine); dumping syndrome (rapid emptying from the stomach into the small bowel); bezoars (food that forms into a hard mass); band erosion or slippage; bleeding and anemia; diarrhea and nutritional deficiencies; choledocholithiasis (the presence or formation of gallstones); and weight regain.


Bariatric surgical intervention presents new challenges to the endoscopist:

  • An upper endoscopy should be performed in all patients with upper-GI-tract symptoms who are to undergo bariatric surgery.

  • Upper endoscopy should be considered in all patients who are to undergo a Roux-en-Y gastrojejunal bypass (RYGB), regardless of the presence of symptoms.

  • In patients without symptoms and who are not undergoing an endoscopy, noninvasive H pylori testing followed by treatment, if positive, is recommended.

  • In patients without symptoms and who were undergoing gastric banding, a preoperative upper endoscopy should be considered to exclude large hernias that may change the surgical approach.

  • An endoscopic evaluation is useful for diagnosis and management of postoperative bariatric surgical symptoms and complications.

  • An endoscopic retrograde cholangiopancreatography (ERCP) is difficult in patients who had a RYGB, and a magnetic resonance cholangiopancreatography (MRCP) should be performed in cases where other noninvasive imaging studies are inconclusive. An ERCP in RYGB patients should be selectively performed.


Contact: Anne Brownsey
American Society for Gastrointestinal Endoscopy

Related medicine news :

1. College Mental Health Expert and Sister of Student Who Died By Suicide Available to Discuss College Mental Health Issues
2. PowerBar Issues Open Call for 2008-2009 PowerBar Team Elite(TM) Athlete Sponsorship Program
3. Crystal Research Associates, LLC Issues Executive Informational Overview(R) (EIO(R)) on Tapestry Pharmaceuticals, Inc.
4. American Red Cross Issues Blood Supply Alert
5. OSHA Issues Draft Ergonomics Guidelines on Preventing Musculoskeletal Injuries in Shipyards
6. New Survey Finds Strong Public Interest in Prescription Drug Safety Issues
7. National Quality Forum Issues First Consensus Standards for the Treatment of Substance Use Conditions
8. Audio: New Survey Finds Strong Public Interest in Prescription Drug Safety Issues
9. Dallas-Area Transplant Meeting Puts Spotlight on Key Issues
10. Elder Care Author Doctor Marion Launches Second National Tour to Raise Awareness About Aging & Elder Care Issues in America
11. California State PTA Issues Statement Regarding Presidents Veto of SCHIP Legislation
Post Your Comments:
(Date:6/27/2016)... ... , ... recently awarded their highest five-star rating to Best Buy Eyeglasses, ... the United States and Canada wear eyeglasses. Once considered to be a purely functional ... a fashion statement. Even celebrities use glasses as a way of creating an iconic ...
(Date:6/26/2016)... , ... June 26, 2016 , ... PawPaws brand ... new product that was developed to enhance the health of felines. The formula is ... The two main herbs in the PawPaws Cat Kidney Support Supplement Soft ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs surgery services, ... Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. , Dr. ... skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was ...
(Date:6/25/2016)... ... ... As a lifelong Southern Californian, Dr. Omkar Marathe earned his Bachelors in ... School of Medicine at UCLA. He trained in Internal Medicine at Scripps Green Hospital ... at the UCLA-Olive View-Cedars Sinai program where he had the opportunity to train in ...
(Date:6/24/2016)... Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... surgery procedures that most people are unfamiliar with. The article goes on to state ... procedures, but also many of these less common operations such as calf and cheek ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
(Date:6/23/2016)... , June 23, 2016 , ... on Thursday, July 7, 2016 , , , , LOCATION: ... , , , , EXPERT PANELISTS:  , , , ... Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and ... The global pharmaceutical industry is witnessing an exceptional era. ...
(Date:6/23/2016)... , June 23, 2016  Guerbet announced today ... Inc.,s Supplier Horizon Award . One ... Guerbet was recognized for its support of Premier members ... through clinical excellence, and commitment to lower costs. ... receive this recognition of our outstanding customer service from ...
Breaking Medicine Technology: