Improving Quality and Safety in the Endoscopy Unit (On-Demand) | August 2023-Guideline_ASGE_appropriate_use_of_gi

Guideline_ASGE_appropriate_use_of_gi_endoscopy

Pdf Summary

This guideline provides information on the appropriate use of gastrointestinal (GI) endoscopy in various clinical situations. The American Society for Gastrointestinal Endoscopy (ASGE) prepared this document based on a critical review of available data and expert consensus. GI endoscopy allows for direct examination of the GI tract, providing greater information than scans and x-rays. It has replaced many surgical procedures and continues to evolve with ongoing technological improvements.<br /><br />The ASGE emphasizes the importance of thorough training in both the cognitive aspects of GI diseases and the technical aspects of endoscopy. The guideline covers a range of GI endoscopic procedures including esophagogastroduodenoscopy (EGD), colonoscopy, flexible sigmoidoscopy (FS), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), enteroscopy, video capsule endoscopy, and natural orifice transluminal endoscopic surgery (NOTES).<br /><br />The guideline provides indications and relative contraindications for each procedure. For example, EGD is generally indicated for upper abdominal symptoms that persist despite therapy, dysphagia, and suspected upper GI pathology. It is generally not indicated for functional symptoms, radiographic findings of sliding hiatal hernia or uncomplicated duodenal ulcer, and routine follow-up of healed benign disease.<br /><br />Colonoscopy is generally indicated for evaluating abnormalities seen on imaging studies, unexplained GI bleeding, iron deficiency anemia, screening and surveillance for colonic neoplasia, and evaluation of chronic inflammatory bowel disease. It is generally not indicated for chronic, stable irritable bowel syndrome, acute diarrhea, metastatic adenocarcinoma of unknown primary site, and routine follow-up of inflammatory bowel disease.<br /><br />The guideline also covers the indications and contraindications for FS, ERCP, EUS, enteroscopy, and video capsule endoscopy. The document highlights the importance of clinical judgment and individualized patient care, stating that clinical considerations may lead to a course of action that deviates from the guideline.<br /><br />In summary, this guideline provides comprehensive information on the appropriate use of GI endoscopy in various clinical scenarios. It emphasizes the importance of proper training and the need for individualized patient care.

Keywords

gastrointestinal endoscopy

clinical situations

training

cognitive aspects

technical aspects

indications

contraindications

colonoscopy

endoscopic ultrasound

individualized patient care