Position Statements represent a consensus of best practice based on the available evidence at the time of preparation. These are not guidelines, and the statements may not apply in all situations and should be interpreted in the light of specific clinical situations and resource availability.
Position Statement on the Assessment and Management of Idiopathic Gastroparesis - November 2025
The purpose of this document is to provide Australia’s first national clinical guidance on the assessment and management of idiopathic gastroparesis (IGP). It responds to growing recognition that IGP is a complex sensorimotor disorder rather than solely a motor disorder defined by delayed gastric emptying. The position statement consolidates current evidence and expert consensus into 20 graded recommendations that reflect contemporary understanding of IGP and its overlap with functional gastroduodenal and eating disorders.
This document aims to promote consistent, evidence-based care across Australia by guiding clinicians in applying a multidisciplinary, biopsychosocial model of management. It emphasises holistic assessment, including medical, nutritional and psychological factors, and supports treatment approaches that minimise harm, address psychosocial comorbidities and improve quality of life for people living with IGP.
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Position Statement - Clinical Practice Recommendations – Periprocedural GLP-1/GIP RA Use – April 2025
This document is to provide recommendations for managing patients taking glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual GLP-1/glucose-dependent insulinotrophic peptide receptor co-agonists (GLP-1/GIPRAs) prior to anaesthesia or sedation for surgical and endoscopic procedures.
This advice applies to all practitioners providing moderate to deep procedural sedation or anaesthesia. Although focused on surgical and endoscopic procedures, the principles should apply to any procedures requiring anaesthesia or sedation
In response to case reports and large case series of retained gastric contents and pulmonary aspiration during sedation for endoscopic procedures or general anaesthesia in people with diabetes and/or obesity treated with GLP-1RAs or GLP-1/GIPRAs, a clinical practice recommendation regarding the periprocedural use of GLP-1RAs and GLP-1/GIPRAs has been co-authored and updated by representatives from ADS, NACOS, GESA and ANZCA. The below represents a consensus based on review of currently available evidence and expert opinion. Although the current level of evidence remains limited, new data and other multidisciplinary clinical guidelines [1, 2] have been considered. This document was written to mitigate the risk of pulmonary aspiration with the periprocedural use of GLP-1RAs and GLP-1/GIPRAs which, although rare, is high-risk and potentially fatal.
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Position Statement on Bidirectional Endoscopy (BDE) – September 2024
Bidirectional endoscopy (BDE), defined as same-day upper and lower gastrointestinal endoscopy, is often performed to evaluate gastrointestinal presentations and abnormalities. When used appropriately, BDE can improve patient outcomes and potentially minimise risk, as well as being potentially cost-effective. However, when BDE is used inappropriately, and endoscopy is performed with no or a low-value indication, it may result in risks to the patient that are greater than the benefit and disproportionate to cost. Endoscopy without an indication or low-value care should be avoided.
In formulating this Australian and Aotearoa New Zealand position statement, we highlight specific scenarios in which BDE is strongly recommended and others where it may be beneficial when supported by good clinical practice. We describe scenarios where endoscopy is either not indicated or of low or negligible clinical benefit and thus BDE is not routinely recommended. To enable delivery of high-quality, high-value, equitable and patient-centred care, BDE should only be performed when there is an appropriate indication for both upper and lower endoscopy and combining these procedures is clinically justified.
This Gastroenterological Society of Australia (GESA) initiative was undertaken in collaboration with the Royal Australasian College of Surgeons (RACS) and endorsed by GESA, the New Zealand Society of Gastroenterology (NZSG) and the Royal Australasian College of Physicians (RACP).
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Position Statement on Quality Standards for Upper Gastrointestinal (UGI) Endoscopy – September 2024
Quality standards for upper gastrointestinal (UGI) endoscopy are required to identify key quality indicators that are relevant to Australasian endoscopic practice and local patient populations. Such standards will promote equitable access to high-quality UGI endoscopy for appropriate indications across Australia and Aotearoa New Zealand.
The Gastroenterological Society of Australia (GESA) Endoscopy Faculty’s quality of UGI endoscopy working group conducted a review of published guidelines on quality standards in UGI endoscopy. The recommendations in this position statement are categorized into preprocedural, intraprocedural and post-procedural. As UGI endoscopy examines several anatomical structures and is performed for a wider range of indications than colonoscopy, disease-specific intraprocedural recommendations for common benign and premalignant conditions of the UGI tract are also presented.
This GESA initiative was undertaken in collaboration with the RACS and endorsed by GESA, the RACS, the Royal Australasian College of Physicians and EGGNZ, membership of which includes the New Zealand Society of Gastroenterology, the New Zealand Association of General Surgeons and other local endoscopy stakeholders.
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GESA Advisory - Part A: Telehealth Consultations and Item Numbers and Part B: Telehealth Code of Conduct - July 2022
Position Statement on Prostheses List Reform – with Reference to Endoscopic Haemostatic Clips – November 2021
The statements and guidelines expressed as endorsed on the GESA website have been endorsed as general documents having appropriate regard to the general circumstances to which they apply at the time of their endorsement. It is the responsibility of the user to have express regard to the particular circumstances of each case and to the application of the statements and guidelines in each case.
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Position Statement on Nurse Endoscopy - April 2021
The statements and guidelines expressed as endorsed on the GESA website have been endorsed as general documents having appropriate regard to the general circumstances to which they apply at the time of their endorsement. It is the responsibility of the user to have express regard to the particular circumstances of each case and to the application of the statements and guidelines in each case.
GESA’s endorsement is applicable at the time at which the endorsement is expressed. The statements and guidelines, developed by third parties, may be reviewed and updated from time to time. GESA does not take responsibility for reviewing its endorsements. It is the responsibility of the user to ensure they have obtained the current version and are aware of more recent or more appropriate statements and guidelines.
The statements and guidelines have been prepared with regard to the information available at the time of preparation (and applicable at the time of GESA’s endorsement) and the user should therefore have regard to any information, research or other material which may have been published or become available subsequently. GESA takes no responsibility in this case.
GESA aims to ensure that professional documents are as current as possible at the time of their endorsement. GESA takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.
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Position Statement on Simethicone Use During Gastrointestinal Endoscopy - June 2019
This position statement is based on a careful assessment of the current literature regarding the benefits and potential risks of the use of simethicone in endoscopy.
Each medical facility should make its own determination regarding the use of simethicone during endoscopic procedures and the route of administration.
Medical facilities that coordinate endoscopy should have access to any information, research or other material which may have been published or become available subsequently so they can reassess their position accordingly.
It is not implied that the statement is applicable in all cases or in any particular case but is a general policy document that may provide guidance for users. Users should use their own judgement and consider the particular circumstances of each case. The user should have regard to any information, research or other material which may have been published or become available subsequently.
This statement is current at the time at which the endorsement is expressed. The statement may be reviewed and updated from time to time. GESA does not take responsibility for reviewing its endorsements and it is the responsibility of the user to ensure they have obtained the current version or are aware of more recent or more appropriate statements.
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Position Statement on Infection Control in Endoscopy Guidelines - August 2016
The statements and guidelines expressed as endorsed on the GESA website have been endorsed as general documents having appropriate regard to the general circumstances to which they apply at the time of their endorsement. It is the responsibility of the user to have express regard to the particular circumstances of each case and to the application of the statements and guidelines in each case.
GESA’s endorsement is applicable at the time at which the endorsement is expressed. The statements and guidelines, developed by third parties, may be reviewed and updated from time to time. GESA does not take responsibility for reviewing its endorsements. It is the responsibility of the user to ensure they have obtained the current version and are aware of more recent or more appropriate statements and guidelines.
The statements and guidelines have been prepared with regard to the information available at the time of preparation (and applicable at the time of GESA’s endorsement) and the user should therefore have regard to any information, research or other material which may have been published or become available subsequently. GESA takes no responsibility in this case.
GESA aims to ensure that professional documents are as current as possible at the time of their endorsement. GESA takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.
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