Cargando…

Management of Upper Gastrointestinal Bleeding by an Internist

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 man...

Descripción completa

Detalles Bibliográficos
Autores principales: Saleem, Saad, Thomas, Abell L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110407/
https://www.ncbi.nlm.nih.gov/pubmed/30155380
http://dx.doi.org/10.7759/cureus.2878
_version_ 1783350467761274880
author Saleem, Saad
Thomas, Abell L
author_facet Saleem, Saad
Thomas, Abell L
author_sort Saleem, Saad
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6110407
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-61104072018-08-28 Management of Upper Gastrointestinal Bleeding by an Internist Saleem, Saad Thomas, Abell L Cureus Family/General Practice 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. Cureus 2018-06-25 /pmc/articles/PMC6110407/ /pubmed/30155380 http://dx.doi.org/10.7759/cureus.2878 Text en Copyright © 2018, Saleem et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Family/General Practice
Saleem, Saad
Thomas, Abell L
Management of Upper Gastrointestinal Bleeding by an Internist
title Management of Upper Gastrointestinal Bleeding by an Internist
title_full Management of Upper Gastrointestinal Bleeding by an Internist
title_fullStr Management of Upper Gastrointestinal Bleeding by an Internist
title_full_unstemmed Management of Upper Gastrointestinal Bleeding by an Internist
title_short Management of Upper Gastrointestinal Bleeding by an Internist
title_sort management of upper gastrointestinal bleeding by an internist
topic Family/General Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110407/
https://www.ncbi.nlm.nih.gov/pubmed/30155380
http://dx.doi.org/10.7759/cureus.2878
work_keys_str_mv AT saleemsaad managementofuppergastrointestinalbleedingbyaninternist
AT thomasabelll managementofuppergastrointestinalbleedingbyaninternist