UEG's educational platform for gastroenterology education bringing recordings, courses, guidelines, and more together in one place.

UEG Week Berlin 2025 Recordings Gut Guide online

Rate for better recommendations!

Your feedback helps us show you more of what you like and less of what you dislike!

More of this!

We will show you more similar content.

Not for me!

We won't suggest this again.

Bookmark!

Save this content for later!

New to myUEG? Create an account! Log In with myUEG account

UEG Poster

Standard Poster

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Free for all myUEG account holders. Your access level is set automatically based on your occupation. Medical professionals get full access to all content. If you are a non-medical user, you can only access UEG Week content from congresses you attended.

Not sure what you can access? Learn more about account types.

Introduction

Proton pump inhibitors (PPIs) are one of the most frequently prescribed drugs with high risk of the over-prescription.

Aims & Methods

Objective: to find potential sources of the over-prescription by analysis of prescription policy and its evolution in time by means of descriptive statistics
Methods: Analysis from the National Registry of Reimbursed Health Services (2010-2022) was performed targeting reimbursed prescription of ATC group A02BC (PPIs) and A02BA (H2 receptor blockers) with respect to the age of patient and prescribing specialist.

Results

More than 300 million defined daily doses (DDD) of antisecretory drugs were prescribed in 2022; PPIs represent the vast majority (296.2 million, 99 %). This volume rose 2.6 times during the 13 years span, the speed of rise is slowing but still 2.4 % yearly.
PPI were prescribed to 1.314 million of patients in 2022 and this number also rose 1.5 times for 13 years. 48 % of PPI users in 2022 were seniors over 65 years, majority of patients treated by PPIs was in 7th decade of life (24 %), while it was 6th decade till 2018 - age of patients rose in the observed period. PPI was prescribed to more than 12 % of the overall population in 2022, but to 29 % of senior population over 65 years of age!
Vast majority of PPI prescription (in DDD) is realized by general practitioners (GP, 67.8 %). The highest proportion of non-GP prescription (95.5 million DDDs) is realized by: gastroenterology (26.9 %), internal medicine (19.2 %), cardiology (9 %), rheumatology (6.1 %) and ENT (ears-nose-throat, 5.4 %). While overall PPI prescription (in DDD) rose 2.6 times during the last 13 years; higher increment was reached by ENT (18.7 times), allergology/immunology (5.7 times), pneumology (4.4 times); cardiology (4 times) and rheumatology (3.1 times).

Conclusion

Global volume of PPI prescription is overwhelming and covers almost a third of senior population. The rise during 13 years was 2.6 times in DDD and 1.5 times in the number of patients; and probably approaches the plateau. GPs are responsible for longstanding maintenance prescription and realize more than 2/3 of the volume. Prescription by specialist probably mirrors rather introductions of prescription. Prophylactic co-prescription with antithrombotic agents and NSAIDs can be responsible for increase in cardiology and rheumatology. Excessive increase of prescription in ENT (and to less extent pneumology and allergology/immunology) is probably to the account of extraesophageal reflux (EER). Routine long-term prescription of PPI for EER (which has no unequivocal diagnostic criteria so far) is a matter of debate because profit was proven dominantly in patients with simultaneous “classical” gastroesophageal reflux symptoms (1,2). EER can be a target population for de-prescribing strategies.

References

Krause AJ. Review article: diagnosis and management of laryngopharyngeal reflux. Aliment Pharmacol Ther. 2024;00:1-16.
Raghu G. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Resp Crit Care Medicine 2022;9:e18-e47.

EPIDEMIOLOGY OF PROTON PUMP INHIBITOR PRESCRIPTION IN THE CZECH REPUBLIC

Jiri Cyrany 1, Michal Vysoudil 2, Jiří Jarkovský 3, Stepan Sembera 1, Paula Moravkova 1, Stanislav Rejchrt 1, Ilja Tachecí 1

1 Charles University, Medical Faculty and University Hospital Hradec Kralove, Hradec Kralove, Czechia

2 Institute of Health Information and Statistics of the Czech Republic, Praha, Czechia

3 Institute of Health Information and Statistics of the Czech Republic, Praha, Czechia|||Institute of Biostatistics and Analyses, Medical Faculty, Masaryk University, Brno, Czechia

Conference

UEG Week Vienna 2024

Topics

Oesophagus

Submission format

Abstract

Session

OESOPHAGEAL, GASTRIC AND DUODENAL (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

UEG Podcast Episode

UEG Podcast

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Part 1: Nageshwar Reddy - How endoscopy has changed

Duvvur Nageshwar Reddy, Pradeep Mundre

Topics

Endoscopy

Published

2026

UEG Podcast Episode

New

UEG Podcast

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Topics

Small Intestine & Nutrition

Published

2026

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Main recommendations

The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast- enhanced computed tomography (CT) scan.

1 ESGE recommends colonic stenting to be reserved for patients with clinical symptoms and radiological signs of malignant large-bowel obstruction, without signs of perforation. ESGE does not recommend prophylactic stent placement.
Strong recommendation, low quality evidence.

2 ESGE recommends stenting as a bridge to surgery to be discussed, within a shared decision-making process, as a treatment option in patients with potentially curable left-sided obstructing colon cancer as an alternative to emergency resection.
Strong recommendation, high quality evidence.

3 ESGE recommends colonic stenting as the preferred treatment for palliation of malignant colonic obstruction.
Strong recommendation, high quality evidence.

4 ESGE suggests consideration of colonic stenting for malignant obstruction of the proximal colon either as a bridge to surgery or in a palliative setting.
Weak recommendation, low quality evidence.

5 ESGE suggests a time interval of approximately 2 weeks until resection when colonic stenting is performed as a bridge to elective surgery in patients with curable left-sided colon cancer.
Weak recommendation, low quality evidence.

6 ESGE recommends that colonic stenting should be performed or directly supervised by an operator who can demonstrate competence in both colonoscopy and fluoroscopic techniques and who performs colonic stenting on a regular basis.
Strong recommendation, low quality evidence.

7 ESGE suggests that a decompressing stoma as a bridge to elective surgery is a valid option if the patient is not a candidate for colonic stenting or when stenting expertise is not available.
Weak recommendation, low quality evidence.

Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

Jeanin van Hooft

Publisher

European Society of Gastrointestinal Endoscopy

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Endoscopy

Citation

Endoscopy. 2020 May;52(5):389-407

Published

2020

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Not sure what you can access? Learn more about account types.

Bariatric surgery: Still the gold standard?

Herbert Burgos Quiros 1

1 GastroClinica, San Jose, Costa Rica

Event

UEG Week Berlin 2025

Topics

Endoscopy Mechanisms & Personalised Medicine Surgery

Session

Obesity in Pan America

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

TAILORING ENDOSCOPIC GASTROPLASTY FOR PERSONALIZED OBESITY TREATMENT: 18-MONTH RESULTS OF THREE TECHNIQUES ACROSS OBESITY CLASSES

Not sure what you can access? Learn more about account types.

Introduction

Endoscopic gastroplasty (EG) is a minimally invasive endoscopic treatment aimed at reshaping the gastric body to manage obesity. This approach is now applicable across all obesity grades. Currently, three EG techniques are commonly used in clinical practice: endoscopic sleeve gastroplasty (ESG), endoluminal vertical gastroplasty (EVG), and distal primary obesity surgery endoluminal (POSE-2).

Aims & Methods

This randomized, single-center clinical trial (ClinicalTrials.gov NCT04854317) included obese individuals undergoing EG using one of the three methods (ESG, EVG, or POSE-2). A subgroup analysis based on obesity classes was performed to determine which technique yields the most favorable outcomes within each class, aiming to support a more tailored, patient-specific treatment approach for obesity. The primary outcomes assessed were weight loss efficacy, improvement in obesity-related comorbidities, and enhancement of quality of life (QoL) across obesity categories.

Results

Between July 2020 and April 2023, 183 patients with obesity (mean BMI 36.3±2.9 kg/m²; mean age 45±10 years; 89.1% female; 57.4% in class II obesity; hepatic steatosis present in 83%) underwent EG using ESG, EVG, or POSE-2. Follow-up adherence was 56.3% at 6 months, 32.8% at 12 months, and 15.8% at 18 months. At these time points, total body weight loss (TBWL) averaged 15.5±6.0%, 14.5±8.5%, and 17.1±10.2%, respectively, while excess weight loss (EWL) was 39.3±15.5%, 36.7±21.3%, and 43.0±26.6%. No significant differences were observed among the three techniques in either TBWL (p=0.92) or EWL (p=0.93) at 18 months.
When stratified by obesity class, there were no significant differences in TBWL (p=0.92) or EWL (p=0.62) among the techniques. However, analyzing technique performance within each obesity class revealed that POSE-2 was superior in class I obesity (p=0.03 for TBWL; p=0.006 for EWL), but less effective in class III (p=0.003). In contrast, EVG showed the best results in class III (p=0.048 for TBWL; p=0.02 for EWL), but underperformed in class I (p=0.034). No significant differences were noted between techniques in class II obesity. Improvements in fatty liver disease, hypertension, hyperlipidemia, diabetes, and obstructive sleep apnea were noted across all groups. Additionally, QoL, as assessed by the BAROS score, significantly improved over 18 months (p<0.001), with no variation across obesity classes.

Conclusion

Endoscopic gastroplasty proved effective in managing obesity. POSE-2 was most beneficial for patients with class I obesity, while ESG and EVG showed greater efficacy in higher obesity classes during mid-term follow-up. These results may support a more personalized therapeutic strategy for obesity.