Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives

Lisanne Holster, Ernst Kuipers

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Abstract

Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%. The vast majority of these bleeds are due to peptic ulcers. Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease. Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB, and is recommended within 24 h of presentation. Proton pump inhibitor (PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy, but has no effect on rebleeding, mortality and need for surgery. Endoscopic therapy should be undertaken for ulcers with high-risk stigmata, to reduce the risk of rebleeding. This can be done with a variety of modalities. High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality, particularly in patients with high-risk stigmata. (C) 2012 Baishideng. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)1202-1207
Number of pages6
JournalWorld Journal of Gastroenterology
Volume18
Issue number11
DOIs
Publication statusPublished - 2012

Research programs

  • EMC MM-04-20-01

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