[Prevention and therapy of acute gastrointestinal hemorrhage]

85% of all gastrointestinal bleeding occurs in the upper gastrointestinal tract. For this reason prophylactic and therapeutic efforts concentrate on the esophagus, stomach and duodenum. Prophylaxis of stress ulcers with H2-blockers and, in some specially endangered patients, with a combination treatment is well accepted. In regard to therapy of bleeding complications, however, medical and surgical treatment procedures compete. Stopping the bleeding during diagnostic endoscopy has gained considerable importance. Success depends - just as does success of pharmacotherapy - upon intensity of bleeding and morphology of the bleeding source (Forrest criteria). For prophylaxis of bleeding relapses from peptic lesions H2-blockers in combination with antacids or pirenzepine are treatment of choice.