TY - JOUR
T1 - Practical guideline on obesity care in patients with gastrointestinal and liver diseases – Joint ESPEN/UEG guideline
AU - Bischoff, Stephan C.
AU - Ockenga, Johann
AU - Eshraghian, Ahad
AU - Barazzoni, Rocco
AU - Busetto, Luca
AU - Campmans-Kuijpers, Marjo
AU - Cardinale, Vincenzo
AU - Chermesh, Irit
AU - Kani, Haluk Tarik
AU - Khannoussi, Wafaa
AU - Lacaze, Laurence
AU - Léon-Sanz, Miguel
AU - Mendive, Juan M.
AU - Müller, Michael W.
AU - Tacke, Frank
AU - Thorell, Anders
AU - Vranesic Bender, Darija
AU - Weimann, Arved
AU - Cuerda, Cristina
N1 - Publisher Copyright:
© 2023 European Society for Clinical Nutrition and Metabolism
PY - 2023/6
Y1 - 2023/6
N2 - Background: Patients with chronic gastrointestinal disease such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), celiac disease, gastroesophageal reflux disease (GERD), pancreatitis, and chronic liver disease (CLD) often suffer from obesity because of coincidence (IBD, IBS, celiac disease) or related pathophysiology (GERD, pancreatitis and CLD). It is unclear if such patients need a particular diagnostic and treatment that differs from the needs of lean gastrointestinal patients. The present guideline addresses this question according to current knowledge and evidence. Objective: The present practical guideline is intended for clinicians and practitioners in general medicine, gastroenterology, surgery and other obesity management, including dietitians and focuses on obesity care in patients with chronic gastrointestinal diseases. Methods: The present practical guideline is the shortened version of a previously published scientific guideline developed according to the standard operating procedure for ESPEN guidelines. The content has been re-structured and transformed into flow-charts that allow a quick navigation through the text. Results: In 100 recommendations (3× A, 33× B, 24 × 0, 40× GPP, all with a consensus grade of 90% or more) care of gastrointestinal patients with obesity – including sarcopenic obesity – is addressed in a multidisciplinary way. A particular emphasis is on CLD, especially metabolic associated liver disease, since such diseases are closely related to obesity, whereas liver cirrhosis is rather associated with sarcopenic obesity. A special chapter is dedicated to obesity care in patients undergoing bariatric surgery. The guideline focuses on adults, not on children, for whom data are scarce. Whether some of the recommendations apply to children must be left to the judgment of the experienced pediatrician. Conclusion: The present practical guideline offers in a condensed way evidence-based advice how to care for patients with chronic gastrointestinal diseases and concomitant obesity, an increasingly frequent constellation in clinical practice.
AB - Background: Patients with chronic gastrointestinal disease such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), celiac disease, gastroesophageal reflux disease (GERD), pancreatitis, and chronic liver disease (CLD) often suffer from obesity because of coincidence (IBD, IBS, celiac disease) or related pathophysiology (GERD, pancreatitis and CLD). It is unclear if such patients need a particular diagnostic and treatment that differs from the needs of lean gastrointestinal patients. The present guideline addresses this question according to current knowledge and evidence. Objective: The present practical guideline is intended for clinicians and practitioners in general medicine, gastroenterology, surgery and other obesity management, including dietitians and focuses on obesity care in patients with chronic gastrointestinal diseases. Methods: The present practical guideline is the shortened version of a previously published scientific guideline developed according to the standard operating procedure for ESPEN guidelines. The content has been re-structured and transformed into flow-charts that allow a quick navigation through the text. Results: In 100 recommendations (3× A, 33× B, 24 × 0, 40× GPP, all with a consensus grade of 90% or more) care of gastrointestinal patients with obesity – including sarcopenic obesity – is addressed in a multidisciplinary way. A particular emphasis is on CLD, especially metabolic associated liver disease, since such diseases are closely related to obesity, whereas liver cirrhosis is rather associated with sarcopenic obesity. A special chapter is dedicated to obesity care in patients undergoing bariatric surgery. The guideline focuses on adults, not on children, for whom data are scarce. Whether some of the recommendations apply to children must be left to the judgment of the experienced pediatrician. Conclusion: The present practical guideline offers in a condensed way evidence-based advice how to care for patients with chronic gastrointestinal diseases and concomitant obesity, an increasingly frequent constellation in clinical practice.
KW - Gastroesophageal reflux disease
KW - Inflammatory bowel disease
KW - Irritable bowel syndrome, celiac disease
KW - Obesity
KW - Pancreatitis
KW - Sarcopenic obesity
UR - https://www.scopus.com/pages/publications/85153956242
U2 - 10.1016/j.clnu.2023.03.021
DO - 10.1016/j.clnu.2023.03.021
M3 - Article
C2 - 37146466
AN - SCOPUS:85153956242
SN - 0261-5614
VL - 42
SP - 987
EP - 1024
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 6
ER -