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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Peptic Ulcer

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Esophageal Varices-I: Introduction

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Gastritis III: Clinical Manifestations and Management01:23

Gastritis III: Clinical Manifestations and Management

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Related Experiment Videos

[Acute massive gastrointestinal bleeding in the elderly].

Akihiro Kimura1, Toshihiko Iwamoto

  • 1Department of Geriatric Medicine, Tokyo Medical University.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|June 13, 2009
PubMed
Summary

Elderly patients taking multiple medications, including NSAIDs and anti-thrombotic agents, face a high risk of gastrointestinal bleeding. Careful medication review is crucial for safe geriatric care.

Related Experiment Videos

Area of Science:

  • Geriatric Medicine
  • Gastroenterology
  • Clinical Pharmacology

Context:

  • Acute massive gastrointestinal bleeding is increasingly prevalent and complex in the elderly.
  • Polypharmacy, including anti-thrombotic agents (ATA) and anti-dementia drugs, contributes to this complexity.
  • Longevity and diverse comorbidities in the elderly population necessitate a closer look at medication-related risks.

Purpose:

  • To investigate the clinical aspects of acute massive gastrointestinal bleeding in elderly patients.
  • To identify the causes and bleeding sites associated with various medications used in geriatric care.
  • To clarify the relationship between drug regimens and gastrointestinal bleeding incidence in the elderly.

Summary:

  • A study of 85 elderly patients (66-95 years) with gastrointestinal bleeding revealed common causes like gastroduodenal ulcers and mucosal lesions.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) and ATA were prevalent (63.5%), particularly in patients with hemorrhagic ulcers.
  • Other geriatric medications such as acetylcholinesterase inhibitors (AchEI), SSRIs, and bisphosphonates were frequently used, often with NSAIDs or ATA, contributing to bleeding risk.

Impact:

  • Highlights the significant risk of drug-related gastrointestinal bleeding in the elderly, extending beyond NSAIDs and ATA.
  • Emphasizes the need for thorough medication history assessment in geriatric patients presenting with GI bleeding.
  • Underscores the importance of cautious NSAID use, even when indicated, in elderly patients on multiple medications.