ASGE Guidelines

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Public Comment

ASGE guidelines approaching publication are available on the website for 30 days for public comment. All reviewers are required to submit a conflict-of-interest disclosure and acknowledge a non-disclosure agreement for the guideline draft. All comments will be reviewed by the SOP Committee. Revisions to the draft are at the discretion of the lead authors and the SOP Committee.

Guidelines

ASGE evidence-based guidelines provide clinicians with recommendations for the evaluation, diagnosis, and management of patients undergoing endoscopic procedures of the digestive tract. Guidelines are not a substitute for physicians’ opinion on individual patients. Final decision on an intervention should always be based on local expertise and patient preferences.

All recommendations follow a rigorous process based on a systematic review of medical literature as outlined by the National Academy of Medicine (formerly Institute of Medicine) standards for guideline development.

Whenever possible, guidelines are based on the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology.

Panels consist of content experts, stakeholders from other specialties, patient representatives, and members of the ASGE Standards of Practice (SOP) Committee.

Each recommendation is based on consideration of the best medical literature, the balance between risks and benefits, cost-effectiveness, patients’ values, and equity. For more information, see the American Society for Gastrointestinal Endoscopy clinical practice guideline development policy and checklist.

Panel members provide ongoing conflict of interest (COI) disclosures, including intellectual conflicts of interest, throughout the development and publication of all guidelines in accordance with the ASGE Policy for Managing Declared Conflicts of Interests.

ASGE strives to provide clinically relevant and practical recommendations, which can help standardize patient care and improve outcomes.

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The following information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.

Newly Published

GRADE Guidelines

Upper GI

Management of ingested foreign bodies and food impactions

Nov 14, 2016, 20:27 PM

Foreign body ingestion and food bolus impaction occur commonly. The majority of ingested foreign bodies will pass spontaneously. Pre-endoscopic series have shown that 80% or more of foreign objects will likely pass without the need for intervention.2,3 However, 2 recent studies have shown that in the setting of intentional ingestion, the rate of endoscopic intervention may be much higher (63%- 76%) and the need for surgical intervention ranges from 12% to 16%.4,5 Mortality rates have been extremely low; a compilation of multiple studies including 2 large series report no deaths in 852 adults and 1 death in 2206 children.

Title : Management of ingested foreign bodies and food impactions

Doi org link : http://dx.doi.org/10.1016/j.gie.2010.11.010

Volume : Gastrointest Endosc 2011; Volume 73, Issue 6; P1085-1091

URL :

Select a choice : Keep

Content created : Jun 2, 2011, 07:23 AM

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ExternalPK : 12544

This is one of a series of statements discussing the use of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text. In preparing this guideline, a search of the medical literature was performed by using PubMed. Studies or reports that described fewer than 10 patients were excluded from analysis if multiple series with more than 10 patients addressing the same issue were available. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time that the guidelines are drafted. Further controlled clinical studies may be needed to clarify aspects of this guideline. This guideline may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice. The original guideline was published in 1995 and last updated in 2002. The recommendations are based on reviewed studies and are graded on the strength of the supporting evidence (Table 1).¹

Guyatt, G.H. ∙ Oxman, A.D. ∙ Vist, G.E. ...

Grade: an emerging consensus on rating quality of evidence and strength of recommendations

Bmj. 2008; 336:924-926

Quality of evidence	Definition	Symbol
High quality	Further research is very unlikely to change our confidence in the estimate of effect	⊕⊕⊕⊕
Moderate quality	Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate	⊕⊕⊕○
Low quality	Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate	⊕⊕○○
Very low quality	Any estimate of effect is very uncertain	⊕○○○

ASGE Guidelines

Public Comment

Guidelines

Newly Published

GRADE Guidelines

Upper GI

Management of ingested foreign bodies and food impactions

Introduction

Diagnosis

Management

Airway

Timing

Equipment

Endoscopes

Retrieval devices

Overtubes

Food bolus impaction

Glucagon

True foreign bodies

Short-blunt objects

Long objects

Sharp-pointed objects

Disk batteries

Magnets

Coins

Narcotic packets

Small-bowel foreign objects

Recommendations

Disclosure

References

Lower GI

Biliary and Pancreatic Endoscopy

Adverse Events

Privileging and Credentialing

GI Endoscopy Unit Operations