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Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145289/ https://www.ncbi.nlm.nih.gov/pubmed/29691276 http://dx.doi.org/10.1136/gutjnl-2018-316276 |
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author | Sung, Joseph JY Chiu, Philip CY Chan, Francis K L Lau, James YW Goh, Khean-lee Ho, Lawrence HY Jung, Hwoon-young Sollano, Jose D Gotoda, Takuji Reddy, Nageshwar Singh, Rajvinder Sugano, Kentaro Wu, Kai-chun Wu, Chun-Yin Bjorkman, David J Jensen, Dennis M Kuipers, Ernst J Lanas, Angel |
author_facet | Sung, Joseph JY Chiu, Philip CY Chan, Francis K L Lau, James YW Goh, Khean-lee Ho, Lawrence HY Jung, Hwoon-young Sollano, Jose D Gotoda, Takuji Reddy, Nageshwar Singh, Rajvinder Sugano, Kentaro Wu, Kai-chun Wu, Chun-Yin Bjorkman, David J Jensen, Dennis M Kuipers, Ernst J Lanas, Angel |
author_sort | Sung, Joseph JY |
collection | PubMed |
description | Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement. |
format | Online Article Text |
id | pubmed-6145289 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-61452892018-09-21 Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 Sung, Joseph JY Chiu, Philip CY Chan, Francis K L Lau, James YW Goh, Khean-lee Ho, Lawrence HY Jung, Hwoon-young Sollano, Jose D Gotoda, Takuji Reddy, Nageshwar Singh, Rajvinder Sugano, Kentaro Wu, Kai-chun Wu, Chun-Yin Bjorkman, David J Jensen, Dennis M Kuipers, Ernst J Lanas, Angel Gut Guidelines Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement. BMJ Publishing Group 2018-10 2018-04-24 /pmc/articles/PMC6145289/ /pubmed/29691276 http://dx.doi.org/10.1136/gutjnl-2018-316276 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Guidelines Sung, Joseph JY Chiu, Philip CY Chan, Francis K L Lau, James YW Goh, Khean-lee Ho, Lawrence HY Jung, Hwoon-young Sollano, Jose D Gotoda, Takuji Reddy, Nageshwar Singh, Rajvinder Sugano, Kentaro Wu, Kai-chun Wu, Chun-Yin Bjorkman, David J Jensen, Dennis M Kuipers, Ernst J Lanas, Angel Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title | Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title_full | Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title_fullStr | Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title_full_unstemmed | Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title_short | Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
title_sort | asia-pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018 |
topic | Guidelines |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145289/ https://www.ncbi.nlm.nih.gov/pubmed/29691276 http://dx.doi.org/10.1136/gutjnl-2018-316276 |
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