ATCO.MED.B.020 Digestive system

                                                                                            Regulation (EU) 2015/340

 

(a) Applicants with any sequelae of disease or surgical intervention in any part of the digestive tract or its adnexa likely to cause incapacitation, in particular any obstruction due to stricture or compression, shall be assessed as unfit. 

(b) Applicants shall be free from herniae that might give rise to incapacitating symptoms.

(c) Applicants with disorders of the gastrointestinal system, including those in points (1) to (5) may be assessed as fit subject to a satisfactory gastroenterological evaluation after successful treatment or full recovery after surgery:

(1) recurrent dyspeptic disorder requiring medication;

(2) pancreatitis;

(3) symptomatic gallstones;

(4) an established diagnosis or history of chronic inflammatory bowel disease;

(5) after surgical operation on the digestive tract or its adnexa, including surgery involving total or partial excision or a diversion of any of these organs.

AMC1 ATCO.MED.B.020 Digestive system

ED Decision 2015/010/R

(a) Oesophageal varices

Applicants with oesophageal varices should be assessed as unfit.

(b) Pancreatitis

(1) Applicants with pancreatitis should be assessed as unfit. A fit assessment may be considered if the cause (e.g. gallstone, other obstruction, medication) is removed.

(2) Alcohol may be a cause of dyspepsia and pancreatitis. If considered appropriate, a full evaluation of its use or misuse should be undertaken.

(c) Gallstones

(1) Applicants with a single large gallstone may be assessed as fit after evaluation.

(2) Applicants with multiple gallstones may be assessed as fit while awaiting treatment  provided the symptoms are unlikely to interfere with the safe exercise of the privileges of the licence.

(d) Inflammatory bowel disease

Applicants with an established diagnosis or history of chronic inflammatory bowel disease may be assessed as fit if the disease is in established stable remission, and only minimal, if any, medication is being taken. Regular follow-up should be required.

(e) Dyspepsia

Applicants with recurrent dyspepsia requiring medication should be investigated by internal examination including radiologic or endoscopic examination. Laboratory testing should include haemoglobin assessment and faecal examination. Any demonstrated ulceration or significant inflammation requires evidence of recovery before a fit assessment may be considered.

(f) Digestive tract and abdominal surgery

Applicants who have undergone a surgical operation on the digestive tract or its adnexa, including a total or partial excision or a diversion of any of these organs, should be assessed as unfit. A fit assessment may be considered if recovery is complete, the applicant is asymptomatic and the risk of secondary complication or recurrence is minimal.