gastrointestinal disorders
Endoscopy
Contraindications to Gastrointestinal Endoscopy
Absolute contraindicationsto endoscopy include Shock Acute myocardial infarction Peritonitis Acute perforation Fulminant colitis Relative contraindicationsinclude poor patient cooperation, coma (unless the patient is intubated), and cardiac arrhythmias or recent myocardial ischemia. Patients taking anticoagulants or chronic nonsteroidal anti-inflammatory drug therapy can safely undergo diagnostic endoscopy. However, if there is a possibility that biopsy or photocoagulation will be done, anticoagulants should be stopped for an appropriate interval before the procedure ( Contraindications references ). Oral iron-containing medications should be stopped 4 to 5 days before colonoscopy because certain green vegetables interact with iron to form a sticky residue that is difficult to remove with a bowel preparation and interferes with visualization. ). The American Society for Gastrointestinal Endoscopy also recommends against antibiotic prophylaxis before any gastrointestinal procedures in patients with synthetic vascular grafts or other nonvalvular cardiovascular devices (eg, implantable electronic devices) or for patients with an orthopedic prosthesis ( Contraindications references ). However, antibiotics are used before placement of a percutaneous endoscopic gastrostomy (PEG) tube to prevent site infection and may benefit peritoneal dialysis patients before colonoscopy. 1.Acosta RD, Abraham NS, Chandrasekhara V, et al: The management of antithrombotic agents for patients undergoing GI endoscopy.Gastrointest Endosc83(1):3–16, 2016. doi: 10.1016/j.gie.2015.09.035.Clarification and additional information.Gastrointest Endosc83(3):678, 2016. 2.ASGE Standards of Practice Committee, Khashab MA, Chithadi KV, et al: Antibiotic prophylaxis for GI endoscopy.Gastrointest Endosc81(1):81–89, 2015. doi: 10.1016/j.gie.2014.08.008 