ASGE Adult and Pediatric Gastroenterology and Endoscopy Board Preparatory and Review Course

Khan_Breakout_Nutrition

Pdf Summary

The ASGE Adult & Pediatric Gastroenterology & Endoscopy Board Preparatory and Review Course covered various topics on nutrition. One case discussed a 52-year-old man who presented with complaints of a new, progressive tremor and slow gait. It was determined that his symptoms were likely due to an excess of manganese, which can occur in patients receiving total parenteral nutrition (TPN) with underlying liver disease.<br /><br />The course also discussed the monitoring of patients receiving TPN. Long-term TPN is used in conditions such as short-bowel syndrome and gastrointestinal fistulae. Recommendations include initiating TPN when oral intake has been inadequate for 7-14 days and deferring the initiation of enteral nutrition (EN) and PN until after the patient is hemodynamically stable. Monitoring involves regular blood tests for various nutrients and electrolytes.<br /><br />Complications of long-term PN were also addressed, including mechanical complications, micronutrient deficiencies, and infections. It was mentioned that patients with significant hepatic disease should avoid trace elements such as copper and manganese, and tight glycemic control is important in critically ill patients.<br /><br />The course touched upon the benefits of bariatric surgery for patients with type 2 diabetes and obesity. It was noted that bariatric surgery can achieve long-term remission in 23-60% of patients with diabetes, and improvement in glycemic control is often evident within days to weeks after surgery.<br /><br />Endoscopic weight loss procedures and their limitations were discussed. It was mentioned that endoscopic therapies may not result in long-term weight loss, with only about 20-25% of patients maintaining their weight loss at five years. Complications of intragastric balloon devices and endoscopic sleeve gastrectomy were also mentioned.<br /><br />Nutrient deficiencies after bariatric surgery were highlighted, including deficiencies in zinc, thiamine, and vitamin B12. The symptoms and treatment for these deficiencies were discussed.<br /><br />Finally, the course covered specific conditions related to nutrition, such as bile acid diarrhea, kidney stones in patients with inflammatory bowel disease, and buried bumper syndrome in patients with percutaneous endoscopic gastrostomy (PEG) tubes.<br /><br />Overall, the course provided a comprehensive overview of various topics related to nutrition in gastroenterology and endoscopy.

Keywords

nutrition

manganese

total parenteral nutrition

monitoring

bariatric surgery

glycemic control

endoscopic weight loss procedures

nutrient deficiencies

inflammatory bowel disease

percutaneous endoscopic gastrostomy