Thomas Eldredge

Thomas Eldredge

Adelaide Medical School

Faculty of Health and Medical Sciences

Dr Tom Eldredge is a General Surgery trainee with the Royal Australasian College of Surgeons. After completing his medical degree in 2014 at the University of Adelaide, he undertook his internship at the Royal Adelaide Hospital, taking a keen interest in teaching and subsequently being appointed as a Clinical Lecturer of the University of Adelaide. Tom completed his PhD in 2022, researching bile reflux in the setting of bariatric surgery and the effect this has on oesophageal function and development of cancer.

My research investigates the incidence, pathophysiology and sequelae of bile reflux in the context of bariatric surgery. 

Nearly two-thirds of Australian adults are overweight or obese – more than two-thirds (70.8%) of adult males, and over half (56.3%) of adult females. Medical treatment of obesity continues to yield disappointing results. Obesity surgery consistently results in effective and sustained weight loss with improved quality of life, and remission of obesity-related diseases. As such, many Australians are turning to surgery to lose weight.

Human evolution

Obesity is an independent risk factor for development of reflux and weight-loss can significantly improve symptoms. Some weight-loss operations, however, can promote bile reflux due to the anatomical alterations, and symptomatic reflux can persist despite weight loss. Bile acids, in conjunction with gastric acid, can cause reflux-type symptoms, and also the development of Barrett’s oesophagus which is a pre-cursor for oesophageal cancer.

Recent advances in obesity surgery include the introduction of new surgical techniques. Currently, the laparoscopic Roux-en-Y gastric bypass (LRYGP) and laparoscopic sleeve gastrectomy (LSG) are the most commonly performed surgical procedures for weight loss worldwide. A newer alternative operative technique is the laparoscopic single anastomosis gastric bypass (LSAGB). This technique is growing in popularity and as described by proponents of the technique, there are many advantages: it is quicker to learn; has a shorter operative time (and thus shorter anaesthetic); reduces risk of complications (one anastomosis rather than two) and weight loss as well as glucose tolerance outcomes are comparable to the other techniques. Despite these results, LSAGB is not being as rapidly adopted by bariatric surgeons as might be expected. The low uptake relates to controversy concerning the theoretical long-term harm and potentially carcinogenic effects of bile reflux into the gastric remnant and the oesophagus after LSAGB.

My clinical trial is the first objective study looking at the incidence of bile reflux in these operative techniques.With current data showing favourable results, including improved efficacy and decreased risk of complications, increased utilisation of the technique will result in improved short-term and long-term patient outcomes. Awareness of the incidence of bile reflux post-operatively will allow clinicians to treat any reflux early, preventing or at least delaying potentially detrimental health outcomes. These interventions will translate into decreased health expenditure, providing net health and economic benefit.

  • Appointments
    Date Position Institution name
    2015 - ongoing Clinical Lecturer University of Adelaide

  • Awards and Achievements
    Date Type Title Institution Name Country Amount
    2021 Research Award Early Career Researcher Award Australian & New Zealand Metabolic and Obesity Surgery Society Australia -
    2019 Award Best Poster and Mini-Oral Presentation (Clinical Projects) 2019 TQEH Research Expo Australia 500
    2019 Scholarship RP Jepson Research Scholarship Royal Australasian College of Surgeons Australia $66,000

  • Education
    Date Institution name Country Title
    2016 - 2022 University of Adelaide Australia Doctor of Philosophy (PhD)
    2009 - 2014 University of Adelaide Australia Bachelor of Medicine / Bachelor of Surgery (MBBS)

  • Postgraduate Training
    Date Title Institution Country
    2019 General Surgery Training Royal Australasian College of Surgeons Australia
    2018 - 2019 Surgical Registrar Royal Adelaide Hospital Australia
    2016 - 2018 Surgical Residency Central Adelaide Local Health Network Australia
    2015 - 2016 Internship Royal Adelaide Hospital Australia

  • Research Interests
    Endocrinology & Metabolism Medical and Health Sciences Metabolic Medicine Public Health Surgery Nutrition and Metabolic Health Surgical and Health Systems Innovation

  • Journals
    Year Citation
    2022 Eldredge, T. A., Bills, M., Ting, Y. Y., Dimitri, M., Watson, M. M., Harris, M. C., . . . Shenfine, J. (2022). Once in a Bile — the Incidence of Bile Reflux Post-Bariatric Surgery. Obesity Surgery, 32(5), 1428-1438.
    DOI Scopus19 WoS6 Europe PMC11
    2022 Gricks, B., Eldredge, T., Bessell, J., & Shenfine, J. (2022). Outcomes of 325 one anastomosis gastric bypass operations: an Australian case series. ANZ Journal of Surgery, 92(9), 2123-2128.
    DOI Scopus4 WoS1 Europe PMC3
    2021 Han, J., Eldredge, T., McQuillan, P., & Prasad, S. (2021). Rare complication of diaphragmatic hernia in a live donor nephrectomy patient. ANZ Journal of Surgery, 91(4), E235-E237.
    DOI WoS2
    2021 Barbaro, A., Eldredge, T. A., & Shenfine, J. (2021). Diagnosing anastomotic leak post-esophagectomy: a systematic review. Diseases of the Esophagus, 34(2), 15 pages.
    DOI Scopus14 WoS7 Europe PMC8
    2020 Eldredge, T. A., Bills, M., Myers, J. C., Bartholomeusz, D., Kiroff, G. K., & Shenfine, J. (2020). HIDA and Seek: Challenges of Scintigraphy to Diagnose Bile Reflux Post-Bariatric Surgery. Obesity Surgery, 30(5), 2038-2045.
    DOI Scopus6 WoS3 Europe PMC2
    2018 Eldredge, T., Myers, J., Kiroff, G., & Shenfine, J. (2018). Detecting Bile Reflux—the Enigma of Bariatric Surgery. Obesity Surgery, 28(2), 559-566.
    DOI Scopus26 WoS15 Europe PMC12
    2018 Eldredge, T. A., Myers, J. C., Kiroff, G. K., & Shenfine, J. (2018). Response to a letter to the editor Re: Detecting bile reflux—the enigma of bariatric surgery. Obesity Surgery, 28(7), 2052.
    DOI
    2018 Eldredge, T. A., Harley, S. J. D., Warren, L. R., & Shenfine, J. (2018). Doctor–doctor: the impact of early career higher degrees in surgical research. ANZ Journal of Surgery, 88(9), 820-822.
    DOI
    2016 Rajak, S. N., Eldredge, T. A., Rashid, F., & Brittain, G. P. (2016). IgG4-related orbital disease mass lesion. Canadian Journal of Ophthalmology, 51(2), e70-e72.
    DOI Scopus3 WoS2 Europe PMC1
    2016 Eldredge, T. A., Rajak, S. N., Taranath, A., & Selva, D. (2016). Proptosis secondarytoorbital bone remodeling from intracranial hypertension. JAMA Ophthalmology, 134(6), 714-716.
    DOI Scopus1

 

Date Years Funding Body Amount
2018 1 Royal Australasian College of Surgeons $66,000
       

 

Tom has been appointed as a Clinical Associate Lecturer within the University of Adelaide and is involved with clinical teaching. He is an oral assessor for entry into the medical program and an examiner for medical student clinical examinations.

Date Course Title Institution Department
2019 - current Instructor - Early Management of Severe Trauma (EMST) Royal Australasian College of Surgeons -
2016 - 2017 Anatomy Demonstrator University of Adelaide Discipline of Anatomy and Pathology
2015 - 2018 Clinical Bedside Tutorials University of Adelaide Clinical Education
2012 Anatomy Tutor St Marks College Adelaide -

 

  • Committee Memberships
    Date Role Committee Institution Country
    2015 - ongoing Member Trainee Medical Officers Systems Improvement Group Royal Adelaide Hospital Australia
    2015 - 2016 Member Resident Medical Officers' Society Royal Adelaide Hospital Australia

  • Memberships
    Date Role Membership Country
    2019 - ongoing Member General Surgeons Australia Australia
    2019 - ongoing Member Royal Australasian College of Surgeons Australia

  • Presentation
    Date Topic Presented at Institution Country
    2021 - 2021 Biliary Scintigraphy provides accurate data on the incidence and extent of bile reflux post-bariatric surgery Annual Scientific Meeting 2021 Australia and New Zealand Society of Nuclear Medicine -
    2019 - 2019 Challenges for Medical Imaging of Bile Reflux after Obesity Surgery TQEH 2019 Research Expo Basil Hetzel Institute Australia
    2018 - 2018 Investigation of Problematic Reflux Symptoms Post-Bariatric Surgery 2018 Annual Conference Australia and New Zealand Metabolic and Obesity Surgery Society -
    2018 - 2018 Detecting Bile Reflux - The Enigma of Bariatric Surgery SA Training Committee Registrar’s Paper Day General Surgeons Australia -
    2017 - 2017 Surgical Research Quality and Output Amongst Junior Doctors in South Australia: A Cross-Sectional Study Annual Scientific Congress Royal Australasian College of Surgeons -
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