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 Associate Lecturer of the University of Adelaide. Currently undertaking a PhD, Tom is 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.

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  • Journals

    Year Citation
    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 Scopus1 WoS1 Europe PMC1
    2018 Eldredge, T., Myers, J., Kiroff, G., & 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., Harley, S., Warren, L., & 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., Eldredge, T., Rashid, F., & Brittain, G. (2016). IgG4-related orbital disease mass lesion. Canadian Journal of Ophthalmology, 51(2), e70-e72.
    DOI Scopus1
    2016 Eldredge, T., Rajak, S., Taranath, A., & Selva, D. (2016). Proptosis secondarytoorbital bone remodeling from intracranial hypertension. JAMA Ophthalmology, 134(6), 714-716.
    DOI

 

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
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 -

 

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  • 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
    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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