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Endoluminal Small Bowel Procedures for Obesity and Metabolic Diseases

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Endoscopy in Obesity Management

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Abstract

The small bowel is an important organ where the majority of nutrient absorption takes place. In addition, it also plays a major role in glucose homeostasis via gut hormone incretins. To date, there are two key incretin hormones that have been identified: glucose-dependent insulinotropic polypeptide (GIP), which is secreted by K cells located predominantly in the duodenum and jejunum, and glucagon-like peptide-1 (GLP-1), which is secreted by L cells found primarily in the ileum and proximal colon. The incretin effect refers to a phenomenon when there is increased stimulation of insulin secretion with oral glucose intake compared to intravenous infusion of the same amount of glucose. This effect is thought to be due to incretin hormones, the function of which is enhanced by a contact between ingested nutrients and the small bowel. In addition to their effect on glucose homeostasis, GIP and GLP-1 also induce satiety and lead to delayed gastrointestinal motility.

Given the role of small bowel on nutrient absorption and glucose homeostasis as described above, endoluminal small bowel procedures appear to have an effect on not only weight loss but also glycemic improvement. To date, there are several small bowel endoscopic bariatric and metabolic therapies (EBMTs). However, none have been FDA-approved for use in the USA. This chapter reviews the currently available small bowel EBMTs, their safety and efficacy data from the pilot and pivotal studies (if available), and the current status of each device as of 2017.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital/Harvard Medical School, 75 Francis Street, Thorn 1404, Boston, MA, 02115, USA

    Pichamol Jirapinyo M.D. & Christopher C. Thompson MD, MSc, FACG, FASGE, AGAF

Authors
  1. Pichamol Jirapinyo M.D.
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  2. Christopher C. Thompson MD, MSc, FACG, FASGE, AGAF
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Corresponding author

Correspondence to Christopher C. Thompson MD, MSc, FACG, FASGE, AGAF .

Editor information

Editors and Affiliations

  1. Gastrointestinal/Minimally Invasive Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois, USA

    Bipan Chand

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Jirapinyo, P., Thompson, C.C. (2018). Endoluminal Small Bowel Procedures for Obesity and Metabolic Diseases. In: Chand, B. (eds) Endoscopy in Obesity Management. Springer, Cham. https://doi.org/10.1007/978-3-319-63528-6_15

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  • DOI: https://doi.org/10.1007/978-3-319-63528-6_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63527-9

  • Online ISBN: 978-3-319-63528-6

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