Management of Upper Gastrointestinal Bleeding by an Internist

Curēus
Saad Saleem, Abell L Thomas

Abstract

Nonvariceal upper gastrointestinal bleeding (UGIB) carries high morbidity and mortality, which can be lowered by timely evaluation and management. This article presents a comprehensive literature review and current guidelines for the management of nonvariceal UGIB by an internist. Pre-endoscopic management includes optimal resuscitation, and making a decision about holding the anticoagulation and antiplatelet therapy versus continuation due to risk of thrombosis. Proton pump inhibitors (PPIs) are beneficial for both ulcer and nonulcer diseases as they reduce the risk of re-bleeding by clot stabilization. Endoscopy should only be performed after hemodynamic stability has been achieved and should not be delayed by more than 24 hours. Resumption of anticoagulation and antiplatelet therapy is based on endoscopic findings and thromboembolic risk. The patient should be discharged on PPIs and should be followed up by a primary care physician.

Citations

Mar 13, 2020·Journal of Paediatrics and Child Health·Eirini KostopoulouAnastasia Varvarigou
Oct 3, 2019·Current Opinion in Gastroenterology·George Mantese
Jul 22, 2020·British Journal of Clinical Pharmacology·Hemda Schmilovitz-WeissAvraham Weiss
Apr 29, 2020·The American Journal of Gastroenterology·Farah Deshmukh, Shamel S Merchant

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Methods Mentioned

BETA
sedation
biopsy

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