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Management of acute gastrointestinal bleeding. Multidisciplinary guideline proposal

Tibor Gyökeres1, Eszter Schäfer1, Attila Szepes2

  • 1Honvédkórház, Gasztroenterológiai Osztály,Magyar Honvédség Egészségügyi Központ, Budapest, Podmaniczky u. 111., 1062.

Orvosi Hetilap
|July 13, 2020
PubMed

Insights

This guideline addresses the increasing challenge of gastrointestinal bleeding, especially in elderly patients on certain medications. It provides a multidisciplinary approach for effective diagnosis and management of digestive bleeding.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Public Health

Background:

  • Gastrointestinal bleeding (GIB) poses a significant public health challenge due to high prevalence and severity.
  • Increasing use of anticoagulants, antiplatelets, and NSAIDs in the elderly exacerbates GIB incidence and complexity.
  • Effective management requires a multidisciplinary approach involving various medical specialists.

Purpose of the Study:

  • To develop a comprehensive, multidisciplinary, practical guideline for managing gastrointestinal bleeding.
  • To provide Hungarian experts' recommendations based on current international guidelines.
  • To address frequently encountered aspects of GIB management.

Main Methods:

  • Development of a local guideline by Hungarian experts.
  • Incorporation of current international guidelines and practical considerations.
  • Structured approach covering initial assessment, risk evaluation, diagnostics, and therapeutics.

Main Results:

  • The guideline details initial patient assessment, risk stratification, and necessary laboratory tests.
  • It outlines hemodynamic resuscitation strategies and diagnostic/therapeutic steps categorized by hemorrhage location.
  • Practical instructions are provided for managing unsuccessful hemostasis and rebleeding, including the role of surgery.

Conclusions:

  • The guideline offers a structured, multidisciplinary framework for managing gastrointestinal bleeding.
  • It emphasizes the importance of early risk assessment and tailored therapeutic interventions.
  • The document serves as a practical resource for clinicians dealing with GIB, particularly in the context of an aging population and polypharmacy.

Keywords:
gastrointestinal hemorrhagegastrointestinalis vérzésguidelineirányelvmultidisciplinarymultidiszciplináris

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