Evidence based guidelines for gastrointestinal endoscopy (GIE) in a tropical setting

Abstract

Upper gastrointestinal endoscopy (UGIE) is fast becoming a very common investigation worldwide. Current guidelines for patients undergoing upper gastrointestinal endoscopy (UGIE) advice at least 6-8 hours fasting for solids and at least 4 hours for liquids. Several anesthetic guidelines now recommend a 2-hour pre-operative fast for clear fluids. We studied if a one hour fast for water was sufficient prior to upper UGIE. We have shown that a one hour fast for water is sufficient prior to UGIE. The six hour fast for solids prior to UGIE advised in most guidelines favours a Western diet. In our second study we set out to examine if this was sufficient in the Asian context where the diet is mainly rice based. We found that a six hour fast is inadequate for a rice based meal and patients should fast at least 10 hrs prior to endoscopy. We then studied the best way to intubate the terminal ileum during colonoscopy. We showed that the 6 o’clock position with the patient prone was the best position for ileoscopy. Nest we looked at if routine ileoscopy was indicated during routine colonoscopy. We showed that routine ileoscopy was indicated during colonoscopy.