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Management of acute upper gastrointestinal bleeding: an update for the general physician

K Siau1, W Chapman, N Sharma

  • 1N Bhala, Department of Gastroenterology, University Hospital, Birmingham, Mindelsohn Way, Birmingham B15 2TH, UK.

The Journal of the Royal College of Physicians of Edinburgh
|February 22, 2018
PubMed

Insights

Acute upper gastrointestinal bleeding (AUGIB) remains a common emergency with high mortality. This review synthesizes the latest evidence and UK guidelines for optimal pre-endoscopic, endoscopic, and post-endoscopic management of AUGIB.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Emergency Medicine

Background:

  • Acute upper gastrointestinal bleeding (AUGIB) is a frequent medical emergency in the UK, presenting every 6 minutes.
  • Despite therapeutic and endoscopic advancements, AUGIB mortality remains high, with over 9,000 annual deaths in the UK.
  • National guidelines exist, yet practice variations and suboptimal care persist, as noted in the 2015 UK National Confidential Enquiry.

Purpose of the Study:

  • To provide a comprehensive review of the optimal management of non-variceal and variceal AUGIB.
  • To integrate the latest evidence and UK-specific guidelines for practical clinical application.
  • To offer guidance for both general physicians and gastroenterologists managing AUGIB.

Main Methods:

  • Literature review incorporating the latest available evidence.
  • Analysis of current UK-relevant guidelines for AUGIB management.
  • Synthesis of pre-endoscopic, endoscopic, and post-endoscopic strategies.

Main Results:

  • Identification of key areas for improvement in AUGIB care.
  • Consolidation of best practices for non-variceal and variceal bleeding.
  • Highlighting the practical value of updated management approaches.

Conclusions:

  • Optimal management of AUGIB requires adherence to evidence-based, guideline-driven protocols.
  • Addressing practice variations is crucial to reduce AUGIB mortality.
  • This review offers a practical framework for enhancing patient care in AUGIB.

Keywords:
gastrointestinal bleedhaemorrhagenon-varicealupper gastrointestinal bleedingvariceal

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