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Gastrointestinal Motility Monitor GIMM
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[Gastrointestinal Bleeding: Update].

Jonel Trebicka1,2, Martin Götz3

  • 1Medizinische Klinik und Poliklinik I, Universitätsklinikum Bonn, Bonn, Deutschland.

Deutsche Medizinische Wochenschrift (1946)
|April 4, 2018
PubMed
Summary
This summary is machine-generated.

Standard endoscopy protocols guide gastrointestinal bleeding (GIB) management. Specific treatments are used for variceal bleeding, while novel endoscopic techniques and early colonoscopy aid in non-variceal bleeding cases.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Gastrointestinal Bleeding

Background:

  • Standard operating procedures are crucial for risk stratification and management of suspected gastrointestinal bleeding (GIB).
  • Specific pharmacological interventions are recommended for suspected variceal bleeding prior to endoscopy.

Purpose of the Study:

  • To outline the diagnostic and therapeutic standards for managing gastrointestinal bleeding (GIB).
  • To review current endoscopic management strategies for both variceal and non-variceal GIB.

Main Methods:

  • Endoscopic management is the gold standard for diagnosing and treating GIB.
  • Emergency endoscopy can be performed regardless of the patient's coagulation status.
  • Propofol is a safe anesthetic option for emergency endoscopy.

Main Results:

  • For non-variceal bleeding, combined injection therapy with mechanical/thermal methods is effective. Novel options like over-the-scope clips and hemostatic powder show promise.
  • Early colonoscopy after bowel lavage is essential for severe lower GIB.
  • For high-risk variceal bleeding, transjugular intrahepatic portosystemic shunt (TIPS) insertion is considered. Stent insertion or balloon compression can manage refractory or recurrent bleeding.

Conclusions:

  • Endoscopic interventions are central to GIB management, with various techniques available for different bleeding types.
  • Timely and appropriate endoscopic procedures, including emergency endoscopy and specific therapies, improve patient outcomes in GIB.