To stop or not to stop Clopidogrel, to bridge or not to bridge Warfarin, that is the question: Antithrombotic Therapy and Endoscopy.

, , , colonoscopy, dyspepsia, endoscopy
There is increasing use of warfarin and antiplatelet agents in the aging population for various indications. These patients are often referred for endoscopy for investigation of abdominal pain, dyspepsia, change of bowel habit, family history of bowel cancer, positive faecal occult blood, anaemia, polyp surveillance etc.
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Obscure Gastrointestinal bleeding: Investigation of the small bowel – The Last Frontier

, , , , endoscopy, enteroscopy
Introduction: Obscure gastrointestinal bleeding (OGIB) is increasingly becoming a common problem in the aging population. These patients, typically, had at least one set of normal gastroscopy and colonoscopy without being able to detect a site of blood loss in the upper or lower gastrointestinal tract.
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Quality in Colonoscopy- Colonoscopist’s Adenoma Detection Rate(ADR)

, , , , , colonoscopy, endoscopy
While colonoscopy and polypectomy reduced incidence of bowel cancer in 76% and reduced bowel cancer related mortality in 53% in a cohort of post-polypectomy pa- tients ( National bowel cancer study), the magnitude of such prevention depends on your colonoscopist’s adenoma detection rate (ADR). Colonoscopist’s ADR is de- fined as the percentage of consecutive screening (asymptomatic) patients who had at least one adenoma removed. A colonoscopist’s ADR is inversely proportional to post-colonoscopy missed cancers and adenomas. Higher the ADR less the missed colorectal cancers (CRC) and polyps (adenomas) for these patients in the post - polypectomy years.
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Eosinophilic Oesophagitis – Not an Uncommon cause of Dysphagia in Adults

dysphagia
Eosinophilic oesophagitis (EO) has been sporadically reported since the 1970s in the children as a cause of dysphagia. In recent times, more and more cases of EO are being reported as a cause of dysphagia and food bolus obstruction in the adult. EO can cause oesophageal strictures and stiffness and is defined by more than 20 eosinophils per high power field in the proximal oesophageal biopsies. Incidence in the children has been reported to be in the range of 1.2 to 1.3 per 10,000 children. Incidence has not been worked out in the adults although some 20% cases of dysphagia or food bolus obstruction would be associated with EO. EO mainly affects the male sex in the 3rd to 4th decade in the adults . Some 7% have family history.
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