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Article ; Online: Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting.

Gong, Joanna Y / Sivaratnam, Dinesh / Armstrong, Emma / Hebbard, Geoffrey S / Brett, Andrew J / Fourlanos, Spiros

2023 Volume 53, Issue 9, Page(s) 1697–1700

Abstract: Delayed gastric emptying occurs in up to 30% of patients with long-standing diabetes and causes significant morbidity. We performed a retrospective cohort study of 341 patients who had participated in a gastric emptying study from 2018 to 2021 in a large ...

Abstract	Delayed gastric emptying occurs in up to 30% of patients with long-standing diabetes and causes significant morbidity. We performed a retrospective cohort study of 341 patients who had participated in a gastric emptying study from 2018 to 2021 in a large teaching hospital. Given the expected prevalence of gastroparesis in people with diabetes, there were fewer studies than anticipated, which could lead to gastroparesis underrecognition.
MeSH term(s)	Humans ; Gastric Emptying ; Gastroparesis/epidemiology ; Gastroparesis/etiology ; Gastroparesis/therapy ; Retrospective Studies ; Diabetes Mellitus ; Hospitals, Teaching
Language	English
Publishing date	2023-09-24
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2045436-3
ISSN	1445-5994 ; 1444-0903
ISSN (online)	1445-5994
ISSN	1444-0903
DOI	10.1111/imj.16221
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Zs.A 792: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Unusual radiological sign in a gentleman with recurrent dysphagia.

Wong, May Y W / Richards, Melissa / Holt, Bronte / Hebbard, Geoffrey S

Frontline gastroenterology

2020 Volume 11, Issue 6, Page(s) 499–500

Language	English
Publishing date	2020-04-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2521857-8
ISSN	2041-4137
ISSN	2041-4137
DOI	10.1136/flgastro-2020-101440
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Zs.A 6880: Show issues

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Article ; Online: Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review.

Peters, Jessica E / Basnayake, Chamara / Hebbard, Geoffrey S / Salzberg, Michael R / Kamm, Michael A

Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society

2021 Volume 34, Issue 8, Page(s) e14278

Abstract: Background: Patients with gastrointestinal disorders are prone to heightened awareness of dietary intake. When diet-related thoughts or behaviors are excessive, they may lead to psychological distress, nutritional compromise, and impair medical ... ...

Abstract	Background: Patients with gastrointestinal disorders are prone to heightened awareness of dietary intake. When diet-related thoughts or behaviors are excessive, they may lead to psychological distress, nutritional compromise, and impair medical treatment. Identification of disordered eating behavior and eating disorders is crucial for effective management, but data on their prevalence within this population remain scarce. We conducted a systematic review of the prevalence of disordered eating behavior and eating disorders in adults with gastrointestinal disorders. Methods: MEDLINE, PubMed, and PsycInfo databases were searched up to June 2021. Studies examining disordered eating in adult patients with a primary gastrointestinal diagnosis were included. Key results: A total of 17 studies met the inclusion criteria for the review. The range of gastrointestinal disorders examined included disorders of gut-brain interaction (DGBI), coeliac disease, and inflammatory bowel disease (IBD). The methods for examining disordered eating were highly variable. The prevalence of disordered eating ranged from 13-55%. The prevalence was higher in patients with disorders of gut-brain interaction (DGBI) than in those with organic gastrointestinal disorders. Factors associated with disordered eating included female sex, younger age, gastrointestinal symptom severity, anxiety and depression, and lower quality of life. Conclusions & inferences: Disordered eating is highly prevalent in adult patients with gastrointestinal illness, particularly those with DGBI. Understanding whether a patient's primary underlying diagnosis is that of an eating disorder or gastroenterological disorder remains a challenge for clinicians. There is an unmet need to identify at-risk patients so that psychological intervention can be included in the therapeutic strategy.
MeSH term(s)	Adult ; Celiac Disease/complications ; Celiac Disease/psychology ; Eating/psychology ; Feeding and Eating Disorders/complications ; Feeding and Eating Disorders/epidemiology ; Female ; Humans ; Prevalence ; Quality of Life
Language	English
Publishing date	2021-10-07
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	1186328-6
ISSN	1365-2982 ; 1350-1925
ISSN (online)	1365-2982
ISSN	1350-1925
DOI	10.1111/nmo.14278
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Zs.A 2979: Show issues

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Article ; Online: Changes in Oesophageal Transit, Macro-Reflux Events, and Gastric Emptying Correlate with Improvements in Gastro-Intestinal Symptoms and Food Tolerance Early Post Sleeve Gastrectomy.

Wickremasinghe, Anagi C / Johari, Yazmin / Yue, Helen / Laurie, Cheryl / Shaw, Kalai / Playfair, Julie / Beech, Paul / Hebbard, Geoffrey / Yap, Kenneth S / Brown, Wendy / Burton, Paul

Obesity surgery

2023 Volume 33, Issue 8, Page(s) 2384–2395

Abstract: Purpose: There are significant alterations in gastro-intestinal function, food tolerance, and symptoms following sleeve gastrectomy (SG). These substantially change over the first year, but it is unclear what the underlying physiological basis for these ...

Abstract	Purpose: There are significant alterations in gastro-intestinal function, food tolerance, and symptoms following sleeve gastrectomy (SG). These substantially change over the first year, but it is unclear what the underlying physiological basis for these changes is. We examined changes in oesophageal transit and gastric emptying and how these correlate with changes in gastro-intestinal symptoms and food tolerance. Material and methods: Post-SG patients undertook protocolised nuclear scintigraphy imaging along with a clinical questionnaire at 6 weeks, 6 months, and 12 months. Results: Thirteen patients were studied: mean age (44.8 ± 8.5 years), 76.9% females, pre-operative BMI (46.9 ± 6.7 kg/m2). Post-operative %TWL was 11.9 ± 5.1% (6 weeks) and 32.2 ± 10.1% (12 months), p-value < 0.0001. There was a substantial increase of meal within the proximal stomach; 22.3% (IQR 12%) (6 weeks) vs. 34.2% (IQR 19.7%) (12 months), p = 0.038. Hyper-accelerated transit into the small bowel decreased from 6 weeks 49.6% (IQR 10.8%) to 42.7% (IQR 20.5%) 12 months, p = 0.022. Gastric emptying half-time increased from 6 weeks 19 (IQR 8.5) to 12 months 27 (IQR 11.5) min, p = 0.027. The incidence of deglutitive reflux of semi-solids decreased over time; 46.2% (6 weeks) vs. 18.2% (12 months), p-value < 0.0001. Reflux score of 10.6 ± 7.6 at 6 weeks vs. 3.5 ± 4.4 at 12 months, (p = 0.049) and regurgitation score of 9.9 ± 3.3 at 6 weeks vs. 6.5 ± 1.7, p = 0.021 significantly reduced. Conclusions: These data demonstrate that there is an increase in the capacity of the proximal gastric sleeve to accommodate substrate over the first year. Gastric emptying remains rapid but reduce over time, correlating with improved food tolerance and reduced reflux symptoms. This is likely the physiological basis for the changes in symptoms and food tolerance observed early post-SG.
MeSH term(s)	Female ; Humans ; Adult ; Middle Aged ; Male ; Gastric Emptying/physiology ; Obesity, Morbid/surgery ; Gastroesophageal Reflux/etiology ; Gastrectomy/methods
Language	English
Publishing date	2023-06-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06695-z
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Zs.A 3381: Show issues

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Article ; Online: The Evaluation of Gastric Emptying Using Nuclear Scintigraphy Compared to Three-Dimensional Multi-detector Computed Tomography (3D-MDCT) Gastric Volumetry in the Assessment of Poor Weight Loss Following Sleeve Gastrectomy.

Wickremasinghe, Anagi / Ferdinands, Jessica / Johari, Yazmin / Ho, Patrick / Leang, Yit / Yue, Helen / Laurie, Cheryl / Beech, Paul / Nadebaum, David P / Yap, Kenneth S / Hebbard, Geoffrey / Brown, Wendy / Burton, Paul

Obesity surgery

2023 Volume 34, Issue 1, Page(s) 150–162

Abstract: Background: Poor weight loss and weight regain are principal challenges following laparoscopic sleeve gastrectomy (LSG). There is a lack of standardised assessments and diagnostic tests to stratify the status post-LSG and determine whether anatomical or ...

Abstract	Background: Poor weight loss and weight regain are principal challenges following laparoscopic sleeve gastrectomy (LSG). There is a lack of standardised assessments and diagnostic tests to stratify the status post-LSG and determine whether anatomical or physiological problem exists. We aimed to compare nuclear scintigraphy gastric emptying with CT volumetric analysis of sleeve anatomy and determine the impact of anatomy on physiological function and its correlation with weight loss. Materials and methods: Patients greater than 12 months post-LSG were categorised into optimal weight loss (OWL) (n = 29) and poor weight loss groups (PWL) (n = 50). All patients underwent a protocolised nuclear scintigraphy and three-dimensional multi-detector computed tomography (3D-MDCT) gastric volumetry imaging. Results: Post-operative % total weight loss in OWL was 26.2 ± 10.5% vs. 14.2 ± 10.7% in the PWL group (p value < 0.0001). The PWL group had significantly more delayed gastric emptying half-time than OWL (34.1 ± 18.8 vs. 19.5 ± 4.7, p value < 0.0001). Gastric emptying half-time showed statistically significant correlations with weight loss parameters (BMI; r = 0.215, p value 0.048, %EWL; r = - 0.336, p value 0.002 and %TWL; r = - 0.379, p value < 0.001). The median gastric volume on 3D-MDCT did not differ between the OWL (246 (IQR 50) ml) and PWL group (262 (IQR 129.5) ml), p value 0.515. Nuclear scintigraphy gastric emptying half-time was the most highly discriminant measure. A threshold of 21.2 min distinguished OWL from PWL patients with 86.4% sensitivity and 68.4% specificity. Conclusion: Nuclear scintigraphy is a potentially highly accurate tool in the functional assessment of sleeve gastrectomy physiology. It appears to perform better as a diagnostic test than volumetric assessment. Gastric volume did not correlate with weight loss outcomes. We have established diagnostic criteria of greater than 21 min to assess sleeve failure, which is linked to suboptimal weight loss outcomes.
MeSH term(s)	Humans ; Gastric Emptying ; Obesity, Morbid/surgery ; Laparoscopy/methods ; Gastrectomy/methods ; Weight Loss/physiology ; Tomography, X-Ray Computed ; Radionuclide Imaging ; Tomography ; Treatment Outcome ; Retrospective Studies
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06951-2
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Zs.A 3381: Show issues

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Article ; Online: Urinary and faecal incontinence: psychological factors and management recommendations.

Kuoch, Kenley Lj / Hebbard, Geoffrey S / O'Connell, Helen E / Austin, David W / Knowles, Simon R

The New Zealand medical journal

2019 Volume 132, Issue 1503, Page(s) 25–33

Abstract: Background: Urinary and faecal incontinence substantially impacts upon physical health and is associated with significant psychological distress and reduced quality of life. Due to stigma and embarrassment, many patients do not present for management of ...

Abstract	Background: Urinary and faecal incontinence substantially impacts upon physical health and is associated with significant psychological distress and reduced quality of life. Due to stigma and embarrassment, many patients do not present for management of their incontinence. Aim: The objective of this article is to summarise the forms and causes of urinary and faecal incontinence, highlight the psychological mechanisms and psychopathology associated with incontinence, and provide management recommendations. Conclusion: Urinary and faecal incontinence can have a significant impact on an individual's psychological wellbeing and quality of life. Psychological factors may either contribute to or arise from incontinence and should be addressed as part of the overall management plan.
MeSH term(s)	Fecal Incontinence/classification ; Fecal Incontinence/etiology ; Fecal Incontinence/psychology ; Fecal Incontinence/therapy ; Humans ; Mental Health ; Patient Care Management/methods ; Psychological Distress ; Quality of Life ; Urinary Incontinence/classification ; Urinary Incontinence/etiology ; Urinary Incontinence/psychology ; Urinary Incontinence/therapy
Language	English
Publishing date	2019-10-04
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	390590-1
ISSN	1175-8716 ; 0028-8446 ; 0110-7704
ISSN (online)	1175-8716
ISSN	0028-8446 ; 0110-7704
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Article ; Online: Delayed Gastric Emptying After Sleeve Gastrectomy Is Associated with Poor Weight Loss.

Wickremasinghe, Anagi Chethana / Johari, Yazmin / Laurie, Cheryl / Shaw, Kalai / Playfair, Julie / Beech, Paul / Yue, Helen / Becroft, Louise / Hebbard, Geoffrey / Yap, Kenneth S / Brown, Wendy / Burton, Paul

Obesity surgery

2022 Volume 32, Issue 12, Page(s) 3922–3931

Abstract: Background: Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We aimed to determine if there were specific esophago-gastric ... ...

Abstract	Background: Intermediate to long-term weight regain is a major challenge following sleeve gastrectomy (SG). Physiological changes that mediate the extent of weight loss remain unclear. We aimed to determine if there were specific esophago-gastric transit and emptying alterations associated with weight regain. Material and methods: Participants greater than 12 months post-SG were categorized into optimal (n = 29) and poor weight loss (PWL) (n = 72). All patients underwent a liquid contrast barium swallow demonstrating normal post-surgical anatomy and a protocolized nuclear scintigraphy designed specifically to characterize gastric emptying following SG. Results: The %total weight loss in the optimal group was 26.2 ± 10.5 vs. 14.3 ± 8.8% in the PWL group (p = 0.001). Scintigraphy showed PWL had relatively increased gastric emptying half-time (GE Conclusion: Gastric emptying half-times greater than 21 min appear to reliably correlate with poor weight loss following SG. Additionally, further elevations above 21 min in emptying half-time increase the risk of poor weight loss. We have shown nuclear scintigraphy represents a simple and accurate diagnostic tool in patients who experience poor weight loss after SG, provided substantially altered reporting references in interpreting nuclear scintigraphy are applied.
MeSH term(s)	Humans ; Obesity, Morbid/surgery ; Gastroparesis/diagnostic imaging ; Gastroparesis/etiology ; Gastrectomy ; Weight Loss/physiology ; Weight Gain ; Gastric Bypass ; Gastric Emptying
Language	English
Publishing date	2022-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-022-06323-2
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Article ; Online: Tubularized and Effaced Gastric Cardia Mimicking Barrett Esophagus Following Sleeve Gastrectomy: Protocolized Endoscopic and Histological Assessment With High-resolution Manometry Analysis.

Johari, Yazmin / Budiman, Kenny / Catchlove, William / Laurie, Cheryl / Hebbard, Geoffrey / Norden, Sam / Brown, Wendy A / Burton, Paul

Annals of surgery

2022 Volume 276, Issue 1, Page(s) 119–127

Abstract: Objective: To describe expected endoscopic and histological changes at gastro-esophageal junction (GEJ) and define diagnostic paradigms for Barrett esophagus (BE) postsleeve gastrectomy (SG).: Summary background data: De novo incidence of BE post SG ... ...

Abstract	Objective: To describe expected endoscopic and histological changes at gastro-esophageal junction (GEJ) and define diagnostic paradigms for Barrett esophagus (BE) postsleeve gastrectomy (SG). Summary background data: De novo incidence of BE post SG was reported as high as 18.8%. A confounding factor is the lack of standardized definition of BE post SG, which may differ from the general population due to procedure-induced alterations of GEJ. Methods: Part 1 involved evaluating endoscopic changes of GEJ post SG (N = 567) compared to pre SG (N = 320), utilizing protocolized preoperative screening, postoperative surveillance and synoptic reporting. Part 2 involved dedicated studies examining causes of altered anatomical and mucosal GEJ appearance using histopathology (N = 55) and high-resolution manometry (HRM) (N = 15). Results: Part 1 - A characteristic tubularized cardia segment projecting supra-diaphragmatically was identified and almost exclusive to post SG (0.6% vs.26.6%, P < 0.001). True BE prevalence was low (4.1%pre SG vs. 3.8%post SG, P = 0.756), esophagitis was comparable (32.1% vs. 25.9%, P = 0.056). Part 2 - Histologically-confirmed BE was found in 12/55 patients, but 70.8% had glandular-type gastric mucosa implying tubularized cardia herniation. HRM of tubularized cardia demonstrated concordance of supra-diaphragmatic cardia herniation between endoscopy and HRM (3 cm vs. 3.2 cm, P = 0.168), with frequent elevated isobaric intraluminal pressurizations in supra-and infra-diaphragmatic cardia compartments. Conclusion: A novel appearance of tubularized cardia telescoping supra-diaphragmatically with flattening of gastric folds is common post SG, likely associated with isobaric hyper-pressurization of proximal stomach. incidence of true BE post SG is low in short-intermediate term. These provided a clear framework for approaching endoscopic screening and surveillance, with correct anatomical and mucosal identifications, and clarified key issues of SG and BE.
MeSH term(s)	Barrett Esophagus/pathology ; Cardia/pathology ; Endoscopy, Gastrointestinal/adverse effects ; Gastrectomy/adverse effects ; Humans ; Manometry
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005493
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Article ; Online: Scleroderma with a twist.

Lim, Eu Jin / Stella, Damien L / Hebbard, Geoffrey S

The American journal of gastroenterology

2010 Volume 105, Issue 10, Page(s) 2297–2299

MeSH term(s)	Adult ; Diagnosis, Differential ; Female ; Gastroparesis/diagnosis ; Humans ; Intestinal Volvulus/complications ; Intestinal Volvulus/diagnosis ; Scleroderma, Diffuse/complications
Language	English
Publishing date	2010-10
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1038/ajg.2010.237
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Article: Managing Barrett's oesophagus.

Hebbard, Geoffrey S / Nandurkar, Sanjay

The Medical journal of Australia

2004 Volume 180, Issue 8, Page(s) 375–376

MeSH term(s)	Adenocarcinoma/etiology ; Adenocarcinoma/prevention & control ; Barrett Esophagus/complications ; Barrett Esophagus/drug therapy ; Esophageal Neoplasms/etiology ; Esophageal Neoplasms/prevention & control ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/drug therapy ; Humans ; Incidence ; Population Surveillance ; Proton Pump Inhibitors ; Risk Factors
Chemical Substances	Proton Pump Inhibitors
Language	English
Publishing date	2004-04-19
Publishing country	Australia
Document type	Comment ; Editorial
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/j.1326-5377.2004.tb05987.x
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