An observational study in Carbon Footprint in Upper GI Endoscopy, Dyspepsia and Non-variceal Upper Gastrointestinal Bleeding, sponsored by King Chulalongkorn Memorial Hospital. Recruiting at 2 sites in Thailand. Open to participants aged 20 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-12-03.
Sponsored by King Chulalongkorn Memorial Hospital · Observational
The goal of this observational study is to learn about the carbon footprint produced from diagnostic upper GI endoscopy in patients with dyspepsia and therapeutic upper GI endoscopy in patients with non-variceal upper GI bleeding. The main question it aims to answer is:
Healthcare systems are a significant source of greenhouse gas (GHG) emissions. Gastrointestinal endoscopy accounts for the third largest share of GHG emissions among hospital services, after anesthesiology and intensive care units. Upper GI endoscopy is commonly indicated for diagnostic purposes, such as dyspepsia, or for therapeutic purposes, such as upper GI bleeding. Carbon footprint is defined as the total amount of GHG emissions over the life cycle of a service or product. Prior studies have primarily estimated the overall footprint of endoscopy, often including indirect sources such as patient transportation, rather than direct emissions. To date, no studies have compared the carbon footprint between diagnostic and therapeutic upper GI endoscopy.
This study aims to provide a detailed assessment of the direct carbon footprint generated by endoscopic procedures. We hypothesize that therapeutic endoscopy for upper GI bleeding has higher carbon emissions due to longer procedure time, greater energy consumption, and increased use of disposable equipment compared to diagnostic endoscopy for dyspepsia.
This study is an observational study looking at patients with dyspepsia and peptic ulcer bleeding coming to receive diagnostic and therapeutic upper GI endoscopy, respectively. Patients coming to receive an upper GI endoscopy at King Chulalongkorn Memorial Hospital and Sawanpracharak Hospital, Thailand, who are under the inclusion criteria, are asked to get enrolled in the study and have their data recorded. Without any intervention, they will be treated with the standard treatment and investigation for their conditions.
The timeframe for patient enrollment is two months. The carbon footprint produced was calculated from medical equipment and medication used, energy consumption, and equipment reprocessing. The carbon footprint produced was calculated from when the patient entered the endoscopy center until they left the endoscopy center.
Patients with peptic ulcer bleeding will either get treatment with a bipolar hemostasis probe, a hemostasis clip, or argon plasma coagulation. Epinephrine injection can also be used as an adjunctive treatment.
The success rate and complications after treatment in patients with peptic ulcer bleeding will be recorded by follow-up at 72 hours and 30 days after the procedure.
The data recorded in this study are age, height, weight, underlying diseases, history of alcohol consumption, history of smoking, duration of endoscopic procedure, types and locations of peptic ulcer (if any) according to Forrest classification, and the success rate of bleeding stoppage. These data will be used to calculate the carbon footprint produced from upper GI endoscopy.
Categorical data will be processed using the chi-square test. Continuous data will be calculated using mean and standard deviation, and compared using the unpaired t-test and ANOVA test.
372 studies on the registry are indexed under Dyspepsia; 67 are open to participants now.
This study's planned enrollment of 75 is below the median of 200 across 62 observational studies indexed under Dyspepsia.
Browse Dyspepsia studies →King Chulalongkorn Memorial Hospital is the lead sponsor of 43 studies on the registry; 11 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Dyspepsia patients and non-variceal upper GI bleeding receiving upper GI endoscopy at King Chulalongkorn Memorial hospital and Sawanpracharak hospital, Thailand
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
For diagnostic endoscopy: Rapid urease test for H. pylori infection For therapeutic endoscopy: stop bleeding with either Argon plasma coagulation or Bipolar hemostasis probe or Hemostasis clip
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.
Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
INR, PT and aPTT (clotting tests)
Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.
Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Dyspepsia patient receiving diagnostic upper GI endoscopy
Non-variceal upper GI bleeding patient receiving therapeutic upper GI endoscopy
To quantify the carbon footprint of diagnostic endoscopy for dyspepsia and therapeutic endoscopy for peptic ulcer bleeding
The primary outcome is to calculate the carbon footprint produced from diagnostic upper GI endoscopy in dyspepsia patients and therapeutic upper GI endoscopy in peptic ulcer patients, focusing on the carbon footprint produced since the patient enter the endoscopy room until they leave the endoscopy room
Time frame: From enrollment to the time that patients leave the endoscopy room
To compare carbon emissions between diagnostic and therapeutic upper GI endoscopy
Time frame: From enrollment to the time that patients leave the endoscopy room
To compare emissions across different hemostatic techniques (clips, argon plasma coagulation, bipolar probe), with or without epinephrine.
Time frame: From enrollment to the time that patients leave the endoscopy room
To evaluate procedural success rates of bleeding stoppage and adverse events (e.g., perforation, post-procedural sepsis) by different techniques
To evaluate procedural success rates of bleeding stoppage and adverse events (e.g., perforation, post-procedural sepsis) by different techniques (follow up to 30 days after treatment was given to see rate of recurrent bleeding)
Time frame: From enrollment to 30 days after treatment
Plan to share: No
No publications or documents are linked to this record.
Ran from Jun 2025 to primary completion in Aug 2025, 2 months.
Of 23 observational studies under Dyspepsia, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 47. This study's 2 months is below that.
How these figures are worked out, and which studies are left out of them.
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