Abstract

Climate change is an escalating global health concern, and healthcare delivery contributes meaningfully to environmental impact, with gastroenterology among the more resource-intensive clinical fields. This narrative review explores the environmental footprint of gastroenterology - especially endoscopic practices - and presents actionable strategies to reduce its carbon emissions without compromising care quality. Endoscopic procedures, high in energy consumption and medical waste generation, contribute substantially to the specialty’s carbon output. Additional contributors include pharmaceutical waste, inefficient waste management, and travel-related emissions from both patients and professionals. The review identifies several practical interventions, such as promoting combined procedures, reducing unnecessary biopsies, adopting reusable accessories, and implementing telemedicine and virtual conferencing to minimize travel. Sustainable disinfection technologies like plasma-activated gas and UVC light, alongside green pharmacy principles and antibiotic stewardship, are highlighted as promising innovations. Barriers to implementation - ranging from economic and regulatory constraints to clinician resistance - are critically examined, with recommendations to embed sustainability in clinical guidelines, staff training, and procurement practices. Real-world case studies underscore the feasibility and benefits of adopting sustainable gastroenterological practices across varied healthcare settings. Ultimately, the review calls for systemic transformation driven by standardized sustainability metrics, investment in green technologies, and equitable global collaboration. As climate change increasingly intersects with gastrointestinal health, greening gastroenterology is not only feasible but imperative for ensuring both environmental and patient well-being.