A obesidade do ponto de vista do gastrenterologista

M. Bispo; P. Barreiro; T. Bana; L. Matos

M. Bispo Interno do Internato Complementar de Gastrenterologia, Serviço de Gastrenterologia – Centro Hospitalar de Lisboa Ocidental, E.P.E. – Hospital de Egas Moniz, Portugal
P. Barreiro Interno do Internato Complementar de Gastrenterologia, Serviço de Gastrenterologia – Centro Hospitalar de Lisboa Ocidental, E.P.E. – Hospital de Egas Moniz, Portugal
T. Bana Interno do Internato Complementar de Gastrenterologia, Serviço de Gastrenterologia – Centro Hospitalar de Lisboa Ocidental, E.P.E. – Hospital de Egas Moniz, Portugal
L. Matos Director do Serviço de Gastrenterologia, Serviço de Gastrenterologia – Centro Hospitalar de Lisboa Ocidental, E.P.E. – Hospital de Egas Moniz, Portugal

Abstract

Background: Along with obesity’s epidemic growth, came the need for new therapeutic options, tendencially less invasive, associated with lower morbidity and lower cost. Gastroenterolgy plays a promissing role in this field, with emerging new endoluminal procedures and the future perspective for transgastric bariatric treatments.
Methods: A literature review was done, selected from computerized medical data bases (MEDSCAPE, MEDLINE), on currently available and investigational bariatric endoscopic procedures.

Results: Several prospective european studies have shown that endoluminal obesity’s treatment with intra-gastric balloon is safe and well tolerated, with satisfactory short and long-term success rates. It allows shorter weight loss when compared to bariatric surgery, but enough to accomplish WHO’s main goals for obesity treatment, with improvement in major medical comorbidities. New endoluminal and transgastric procedures combining the skills and techniques of flexible endoscopy with minimally invasive surgery are under investigation, with the perspective of a future relevant part in obesity’s multidisciplinary management.

Conclusions: Intra-gastric balloon shows high technical and clinical success rates, with prompt improvement in associated medical complications. Evolving endoluminal and transgastric procedures come as valuable therapeutical options in this worldwide health problem.

Keywords: obesity; therapeutic endoscopy; intragastric balloon; bariatric.

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