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Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

by Valeria Confalonieri | Dec 12, 2023

Less invasive tests approved by regulatory agencies as alternatives to gastrointestinal endoscopy are: fecal calprotectin in monitoring patients with inflammatory bowel diseases and in chronic diarrhea; C-13 urea breath test and stool antigen test in diagnosis of...
Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

Do not take mucosal biopsies when the histopathological results would not change the patient management.

by Valeria Confalonieri | Dec 12, 2023

The processing of biopsies entails an added energy requirement and generates hazardous waste and a significant carbon footprint. International Guidelines endorsed strategies to safely avoid the need for histological analysis (use of optical diagnosis, apply the...
Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

Do not plan most elective endoscopic procedures on an inpatient basis if they can be performed safely without hospitalization, to avoid overnight hospital stays.

by Valeria Confalonieri | Dec 12, 2023

Hospitalization for a procedure incurs high resource consumption and CO2 emissions and is associated with the risk of hospital-acquired infections. Several reports support that most elective GI endoscopic procedures should be performed safely on an outpatient basis,...
Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

Do not perform food intolerance tests except for those scientifically validated

by Valeria Confalonieri | Mar 14, 2023

The only validated diagnostic test is lactose breath-test for lactose intolerance. Others test such as VEGA-test, Cytotoxic test, serum specific IgG4 determination, hair analysis, intestinal permeability, salivary IgA, “bioresonance” techniques, fecal microbial...
Do not prescribe endoscopic examination when low-waste, less invasive alternatives endorsed by evidence-based clinical guidelines are available.

Do not request surveillance colonoscopy for asymptomatic colonic diverticular disease without changes in symptoms

by Valeria Confalonieri | Mar 14, 2023

The term merely identifies presence of diverticula in the colon, characterized by a favorable course and, generally, absence of symptoms. Colonoscopy is not indicated in patients with asymptomatic colonic diverticulosis and in patients with symptomatic uncomplicated...
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