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Guidelines

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Click a heading in the right-hand column to see the selected guidelines in that subject area

The latest guidelines are listed below, as well as under the appropriate subject headings

Please send any information about new or relevant guidelines to Guidelines@GastroHep.com

American Gastroenterological Association Institute medical position statement on the management of gastric subepithelial masses.
American Gastroenterological Association Institute This document presents the official recommendations of the American Gastroenterological Association Institute (AGA Institute) on "Management of Gastric Subepithelial Masses." It was approved by the Clinical Practice and Economics Committee on January 19, 2006, and by the AGA Institute Governing Board on April 20, 2006.
American gastroenterological association institute medical position statement on the use of gastrointestinal medications in pregnancy.
Mahadevan U, Kane S. This document presents the official recommendations of the American Gastroenterological Association (AGA) Institute on "Use of Gastrointestinal Medications in Pregnancy." It was approved by the Clinical Practice and Economics Committee on February 22, 2006, and by the AGA Institute Governing Board on April 20, 2006.
American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses.
Hwang JH, Rulyak SD, Kimmey MB; American Gastroenterological Association Institute.  This literature review and the recommendations therein were prepared for the American Gastroenterological Association Institute Clinical Practice and Economics Committee. The paper was approved by the Committee on January 19, 2006, and by the AGA Institute Governing Board on April 20, 2006.
The role of the nurse/associate in the placement of percutaneous endoscopic gastrostomy (PEG) tube.
Society of Gastroenterology Nurses and Associates, Inc. -
Simulators in competence assessment and credentialing: prospects and problems.
Cotton PB. Systems that simulate endoscopic procedures have considerable potential in assessing endoscopic competence and assisting credentialing, but there are significant problems. If it can be shown that simulation tests correlate with real performance, the questions will be how to pay for the infrastructure and staff and how to motivate endoscopists to use them.
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Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Constipation, defined as a delay or difficulty in defecation, present for 2 or more weeks, is a common pediatric problem encountered by both primary and specialty medical providers. The Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) has formulated a clinical practice guideline for the management of pediatric constipation. The Constipation Guideline Committee, consisting of two primary care pediatricians, a clinical epidemiologist, and pediatric gastroenterologists, based its recommendations on an integration of a comprehensive and systematic review of the medical literature combined with expert opinion. Consensus was achieved through Nominal Group Technique, a structured quantitative method. The Committee developed two algorithms to assist with medical management, one for older infants and children and the second for infants less than 1 year of age. The guideline provides recommendations for management by the primary care provider, including evaluation, initial treatment, follow-up management, and indications for consultation by a specialist. The Constipation Guideline Committee also provided recommendations for management by the pediatric gastroenterologist.
Guidelines on Paediatric Parenteral Nutrition
European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR) Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R; Parenteral Nutrition Guidelines Working Group; European Society for Clinical Nutrition and Metabolism; European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN); European Society of Paediatric Research (ESPR.
Guideline for the evaluation of cholestatic jaundice in infants
The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Moyer V, Freese DK, Whitington PF, Olson AD, Brewer F, Colletti RB, Heyman MB; North American Society for Pediatric Gastroenterology, Hepatology and Nutrition For the primary care provider, cholestatic jaundice in infancy, defined as jaundice caused by an elevated conjugated bilirubin, is an uncommon but potentially serious problem that indicates hepatobiliary dysfunction. Early detection of cholestatic jaundice by the primary care physician and timely, accurate diagnosis by the pediatric gastroenterologist are important for successful treatment and a favorable prognosis. The Cholestasis Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has formulated a clinical practice guideline for the diagnostic evaluation of cholestatic jaundice in the infant. The Cholestasis Guideline Committee, consisting of a primary care pediatrician, a clinical epidemiologist (who also practices primary care pediatrics), and five pediatric gastroenterologists, based its recommendations on a comprehensive and systematic review of the medical literature integrated with expert opinion. Consensus was achieved through the Nominal Group Technique, a structured quantitative method.The Committee examined the value of diagnostic tests commonly used for the evaluation of cholestatic jaundice and how those interventions can be applied to clinical situations in the infant. The guideline provides recommendations for management by the primary care provider, indications for consultation by a pediatric gastroenterologist, and recommendations for management by the pediatric gastroenterologist.The Cholestasis Guideline Committee recommends that any infant noted to be jaundiced at 2 weeks of age be evaluated for cholestasis with measurement of total and direct serum bilirubin. However, breast-fed infants who can be reliably monitored and who have an otherwise normal history (no dark urine or light stools) and physical examination may be asked to return at 3 weeks of age and, if jaundice persists, have measurement of total and direct serum bilirubin at that time.This document represents the official recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition on the evaluation of cholestatic jaundice in infants. The American Academy of Pediatrics has also endorsed these recommendations. These recommendations are a general guideline and are not intended as a substitute for clinical judgment or as a protocol for the care of all patients with this problem.
Standards for specialized nutrition support: home care patients
Standards for Specialized Nutrition Support Task Force Kovacevich DS, Frederick A, Kelly D, Nishikawa R, Young L; American Society for Parenteral and Enteral Nutrition Board of Directors.
A framework for management of hepatitis C in prisons
Spaulding AC, Weinbaum CM, Lau DT, Sterling R, Seeff LB, Margolis HS, Hoofnagle JH The prevalence of chronic hepatitis C virus (HCV) infection in prisons ranges from 12% to 31%. There are generally accepted--albeit still evolving--guidelines for identification and treatment of hepatitis C in the community. However, there is less agreement among health professionals caring for prisoners about best practices for identification, medical management, and treatment of hepatitis C. Inmates often lack health care before incarceration. In prisons, infected persons could be identified and the management of infection initiated; however, the high prevalence of HCV infection among prisoners would impose a disproportionate cost for hepatitis C care on the correctional system. The optimal solution is for prison and public health systems in the United States to jointly provide targeted HCV testing and standard-of-care hepatitis C medical management, treatment, and prevention programs to prison inmate populations. The authors report on a January 2003 meeting of experts in prison health, public health, hepatology, and infectious diseases and explore the clinical care, prevention, and collaboration needed to provide hepatitis C management in prisoners.
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The use of gastrointestinal medications in pregnancy
American gastroenterological association institute medical position statement Mahadevan U, Kane S Division of Gastroenterology, Department of Medicine, University of California, San Francisco, USA. This document presents the official recommendations of the American Gastroenterological Association (AGA) Institute on "Use of Gastrointestinal Medications in Pregnancy." It was approved by the Clinical Practice and Economics Committee on February 22, 2006, and by the AGA Institute Governing Board on April 20, 2006.
The management of gastric subepithelial masses
AGA Institute medical position statement American Gastroenterological Association Institute. This document presents the official recommendations of the American Gastroenterological Association Institute (AGA Institute) on "Management of Gastric Subepithelial Masses." It was approved by the Clinical Practice and Economics Committee on January 19, 2006, and by the AGA Institute Governing Board on April 20, 2006.
AGA Institute medical position statement on the use of gastrointestinal medications in pregnancy
Mahadevan U, Kane S This document presents the official recommendations of the American Gastroenterological Association (AGA) Institute on "Use of Gastrointestinal Medications in Pregnancy." It was approved by the Clinical Practice and Economics Committee on February 22, 2006, and by the AGA Institute Governing Board on April 20, 2006.
American Gastroenterological Association medical position statement: evaluation of dyspepsia
Talley NJ; American Gastroenterological Association 
Guidelines for the treatment of Crohn's disease in children
Working Group of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition; Konno M, Kobayashi A, Tomomasa T, Kaneko H, Toyoda S, Nakazato Y, Nezu R, Maisawa S, Miki K. Guidelines for the treatment of Crohn's disease in children by the Working Group of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition (Chair: Yuichiro Yamashiro) and the Japanese Society for Pediatric Inflammatory Bowel Disease (Chair: Akio Kobayashi). The points in which these guidelines differ from those for adult patients are as follows. (i) Total enteral nutrition in the form of an elemental formula is indicated as primary therapy for children with Crohn's disease at onset as well as the active stage. Oral mesalazine is used together. (ii) Total parenteral nutrition (TPN) with oral mesalazine is required for children with serious illness. The use of a corticosteroid should be withheld for at least 1 week after TPN has been started. (iii) When TPN is not considered to be effective, additional corticosteroid is used. Full doses of corticosteroid should be used for at least 2 weeks after clinical improvement has been achieved, and then the dose of the corticosteroid should be tapered carefully. (iv) When surgery is indicated in pediatric patients with stricture or fistula formation and complicated by persistent growth failure despite medical therapy, the optimum time for surgery is thought to be before epiphyseal plates have been closed.
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 21 November 2008

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