2.2. Patients
bleeding, upper gastrointestinal endoscopy, oncologic disease, ferropenic anemia, malnutrition
BLEEDING, FERROPENIC ANEMIA, MALNUTRITION
Consecutive ambulatory patients aged 18 years old or older, referred for PEG with the Artificial Feeding Team (GENE) of the Gastroenterology Department of Hospital Garcia de Orta, were initially eligible. Additional inclusion criteria included oral ingestion below 50% of energy daily needs for a minimum period of one month and/or baseline diagnosis of malnutrition according to the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria [Nutritional anamnesis performed by a trained dietitian through a dietary recall.Estimation of energy needs according to age, gender, height, weight, and clinical setting to assess the reduction in food ingestion in the last month before PEG.Prospective clinical and demographic database registry that includes age, gender, clinical indication for PEG, anthropometry, laboratory parameters, and survival.PEG was performed by two gastroenterologists using the “pull” method described by The collection of 4–6 duodenal biopsies (second portion) at the time of the gastrostomy procedure (T0) and after 3–6 months of PEG feeding at endoscopic tube replacement (T1).All participants or their representatives signed an informed consent form. Patients with oncologic disease, patients who quantified food ingestion above 50% of energy daily needs during the last month before PEG, those with evident inability to provide credible anamnestic data, or those who refused to participate in the study were excluded. The technical inability to obtain duodenal biopsies and the expected impossibility of having an appropriate clinical and nutritional follow-up were additional exclusion criteria.Random healthy individuals who had undergone upper gastrointestinal endoscopy to investigate ferropenic anemia also had duodenal biopsies taken, with them being used as baseline negative controls if no endoscopic and histologic abnormality was diagnosed and a non-duodenal source of bleeding was found.