title: Dietary approaches following endoscopic retrograde cholangiopancreatography: A survey of selected endoscopists.
abstract: OBJECTIVE
  To describe the dietary recommendations of experienced endoscopists for patients who have undergone endoscopic retrograde cholangiopancreatography (ERCP) and the factors that influence these recommendations.
  
  
  METHODS
  Selected U.S. endoscopists with ERCP experience were surveyed by e-mail. A questionnaire with three hypothetical ERCP cases of patients at low, medium and high risk for development of post-ERCP pancreatitis (PEP) was shown. For each scenario, respondents were asked to recommend a post-procedure diet and time to first oral intake. Respondents were also asked about the effect of various clinical factors on their recommendations, including risk of PEP.
  
  
  RESULTS
  97/187 selected ASGE members (51.9%) responded. When risk of PEP was either low, medium or high, 53%, 88% and 96% recommended a diet of clear liquids/NPO respectively, and 2%, 5% and 18% recommended delaying first oral intake until the following day. About 88% of respondents gave the same type of diet to patients at high as those with moderate-risk of PEP (P = 0.04). However, 37% and 43% of respondents gave different types of diet to patients at low vs moderate-risk and low-risk vs high-risk of PEP respectively (P < 0.001). No statistically significant associations were found regarding the effect of other clinical factors or respondent demographics.
  
  
  CONCLUSIONS
  Most experienced endoscopists limit diet to NPO/clear liquids after ERCP for patients at high or moderate risk of post-ERCP pancreatitis. About half allow a low-fat or regular diet in patients at low risk.
authors.affiliation: Lincoln EVVC Ferreira, Department of Medicine, Digestive Endoscopy Unit Hospital Universitario da Universidade Federal de Juiz de For a, Juiz de Fora, MG 36036247, Brasil.
authors.forename: Lincoln Evvc
authors.initials: LE
authors.lastname: Ferreira
authors.forename: Mark D
authors.initials: MD
authors.lastname: Topazian
authors.forename: William S
authors.initials: WS
authors.lastname: Harmsen
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron