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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

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Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Upper GI Series: Barium Swallow01:24

Upper GI Series: Barium Swallow

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Related Experiment Videos

Feeding the patients with upper gastrointestinal bleeding.

Xavier Hébuterne1, Geoffroy Vanbiervliet

  • 1Gastroenterology and Clinical Nutrition, CHU of Nice, University of Nice Sophia-Antipolis, Archet Hospital, Department of Gastroenterology and Nutrition, Nice, France. xavier.hebuteme@unice.fr

Current Opinion in Clinical Nutrition and Metabolic Care
|January 22, 2011
PubMed
Summary

Patients with upper gastrointestinal bleeding can often resume oral or enteral feeding sooner than typically believed. Early refeeding is safe for many conditions, guided by the bleeding cause and endoscopic findings.

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Internal Medicine

Background:

  • Systematic fasting is a common practice for patients with upper gastrointestinal bleeding.
  • Nutritional management in this patient group requires careful consideration of bleeding etiology and risk factors.

Purpose of the Study:

  • To review current evidence on oral and/or enteral feeding in patients with or at risk of upper gastrointestinal bleeding.
  • To challenge the traditional belief of mandatory fasting in these patients.

Main Methods:

  • Systematic review of literature on nutritional interventions for upper gastrointestinal bleeding.
  • Analysis of clinical guidelines and research findings regarding feeding protocols.

Main Results:

  • Enteral nutrition is the optimal prophylaxis for stress ulcers in intensive care unit (ICU) patients.
  • Concomitant use of histamine-2 receptor blockers or proton-pump inhibitors with enteral nutrition may be detrimental.
  • Refeeding can commence as tolerated for bleeding from gastric erosions, gastritis, Mallory-Weiss tears, oesophagitis, or angiodysplasia.
  • A 48-hour delay post-endoscopic therapy is advised for high-risk rebleeding ulcers (Forrest I-IIb) or variceal bleeding before initiating feeding.

Conclusions:

  • The cause of upper gastrointestinal bleeding is crucial for tailoring nutritional strategies.
  • Individualized feeding approaches, based on diagnosis and endoscopic assessment, are recommended over routine fasting.