Archive February 2018 XIX, No. 2

What's New in Upper GI

The latest scope add-ons let gastroenterologists see and do more.

Anna Merriman

Anna Merriman, Associate Editor

BIO

GI Tools
WHAT'S UP? Specialists and their patients are benefitting from new tools and technologies for upper GI procedures.

New technology is making upper GI procedures safer and more efficient. From a spray-on powder that controls bleeds and less invasive weight-loss surgery to treating swallowing disorders and resecting larger and deeper lesions, here are some of the latest tools and techniques you and your GI docs should know about.

1. Stop bleeding with a spray-on coagulating powder

Upper gastrointestinal bleeding (UGIB), caused by everything from peptic ulcers to gastritis, is a common problem in upper GI procedures. Apart from indicating a larger medical issue, bleeding can also obscure visualization during an endoscopy, leaving your GI doctors open to the risk of missing lesions during the procedure. GI docs usually try to stop bleeding with cauterization or by applying a clip to the problem ulcer. But this doesn't always work. A 2010 study found that initial hemostasis was achieved in 85% to 95% of cases when doctors used combined endoscopic therapy, including injecting epinephrine, or by thermal and mechanical means. But that still leaves about a 10% risk of rebleeding.

Now doctors can spray the area of the bleeding with a coagulating powder that only attaches to areas of bleeding and absorbs water molecules, essentially helping to form clots at the site of the bleeding, says Jon Hlivko, MD, assistant professor of internal medicine at Northeast Ohio Medical University in Rootstown, Ohio, who calls the endoscopically-applied powder "immediate hemostasis."

"It creates a matrix when it sprays on the area of bleeding," says Seth Gross, MD, chief of gastroenterology at Tisch Hospital in New York, N.Y.

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