Navigation Links
ASGE issues guidelines on the role of endoscopy in the bariatric surgery patient
Date:7/25/2008

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.

SUMMARY AND RECOMMENDATIONS:

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
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:3/24/2017)... ... March 24, 2017 , ... Texas Physical Therapy ... be found at 9618 Huebner Road. The clinic is the group’s 7th location in ... and Dr. Ali Higgins, PT, will provide care from the clinic, which opened March ...
(Date:3/24/2017)... ... March 24, 2017 , ... In just two days, ... vertical micro-veggies garden on Kickstarter . Surpassing the $100,000 milestone so quickly,10-times ... 2,000 consumers (and counting) already backing the campaign. , “We are very ...
(Date:3/24/2017)... ... March 24, 2017 , ... The law firm of Enea, Scanlan & ... announce Westchester resident Lauren C. Enea has joined the firm as an associate attorney. ... her practice in elder law, Medicaid planning and applications, and Wills, Trusts and Estates. ...
(Date:3/24/2017)... ... 24, 2017 , ... Judy Buchanan, co-owner of Serenity Natural ... Judy says, “I am passionate about sharing Reiki as a holistic, complementary therapy ... challenging time.” , A Certified Medical Reiki™ Master trained by Raven Keys Medical ...
(Date:3/24/2017)... (PRWEB) , ... March 24, 2017 , ... ... collection of inspiring stories about real people of God in congregations across the ... John Miller, a Presbyterian minister ordained in 1964 who has served congregations in ...
Breaking Medicine News(10 mins):
(Date:3/23/2017)... The key factors driving the growth of dialysis ... growth and increasing healthcare expenditure. Some of the noteworthy trends ... ESRD patients, rising demand for home PD treatment and huge ... market is hindered by high treatment costs and stringent regulations. ... Complete ...
(Date:3/23/2017)... -- Executive Summary ... research (inputs from industry experts, companies, stakeholders) and ... analysis of global heart valve devices market on ... Procedure By Technique (Mechanical, Bioprosthetic, Transcatheter Aortic Valve ... Valvuloplasty, Transcatheter Mitral Valve Repair (TMVR)), By Region ...
(Date:3/23/2017)... , March 23, 2017  The U.S. Food ... (avelumab) for the treatment of adults and pediatric patients ... (MCC), including those who have not received prior chemotherapy. ... a rare, aggressive form of skin cancer. ... cancers, patients with a rare form called Merkel cell ...
Breaking Medicine Technology: