Acute Gastrointestinal Bleeding

In the ClinicAugust 6, 2013Acute Gastrointestinal BleedingMeeta Prasad Kerlin, MD, MSCE, Jeffrey L. Tokar, MD, Deborah Cotton, MD, MPH, Darren Taichman, MD, PhD, and Sankey Williams, MDMeeta Prasad Kerlin, MD, MSCESearch for more papers by this author, Jeffrey L. Tokar, MDSearch for more papers by this author, Deborah Cotton, MD, MPHSearch for more papers by this author, Darren Taichman, MD, PhDSearch for more papers by this author, and Sankey Williams, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-3-201308060-01002 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Acute gastrointestinal (GI) bleeding is common in both the outpatient setting and the emergency department. Annual U.S. incidence rates over the past decade are approximately 90–108 per 100 000 persons (1), leading to approximately 300 000 hospitalizations annually. Most cases are due to nonvariceal sources of bleeding (e.g., peptic ulcers) and continue to be associated with significant mortality (3–14%) and health economic burden (1–3). The incidence of nonvariceal bleeding may be decreasing in the West largely because of decreased incidence of Helicobacter pylori infection and increased awareness and implementation of ulcer-prevention strategies in users of nonsteroidal anti-inflammatory drugs (NSAIDs) (1). ...References1. Hreinsson JP, Kalaitzakis E, Gudmundsson S, Björnsson ES. Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting. Scand J Gastroenterol. 2013;48:439-47. [PMID: 23356751] Google Scholar2. Yavorski RT, Wong RK, Maydonovitch C, et al. Analysis of 3,294 cases of upper gastrointestinal bleeding in military medical facilities. Am J Gastroenterol. 1995;90:568-73. [PMID: 7717312] Google Scholar3. Targownik LE, Nabalamba A. Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993-2003. Clin Gastroenterol Hepatol. 2006;4:1459-1466. [PMID: 17101296] Google Scholar4. McColl KE, el-Nujumi AM, Chittajallu RS, et al. A study of the pathogenesis of Helicobacter pylori negative chronic duodenal ulceration. Gut. 1993;34:762-8. [PMID: 8314508] Google Scholar5. Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcer. Nonsteroidal antiinflammatory drugs, Helicobacter pylori, and smoking. J Clin Gastroenterol. 1997;24:2-17. [PMID: 9013343] Google Scholar6. Talamini G, Zamboni G, Cavallini G. Antral mucosal Helicobacter pylori infection density as a risk factor of duodenal ulcer. Digestion. 1997;58:211-7. [PMID: 9243115] Google Scholar7. Barkun AN, Bardou M, Pham CQ, Martel M. Proton pump inhibitors vs. histamine 2 receptor antagonists for stress-related mucosal bleeding prophylaxis in critically ill patients: a meta-analysis. Am J Gastroenterol. 2012;107:507-20. [PMID: 22290403] Google Scholar8. Arisawa T, Tahara T, Shibata T, et al. Association between genetic polymorphisms in the cyclooxygenase-1 gene promoter and peptic ulcers in Japan. Int J Mol Med. 2007;20:373-8. [PMID: 17671743] Google Scholar9. Malaty HM, Graham DY, Isaksson I, Engstrand L, Pedersen NL. Are genetic influences on peptic ulcer dependent or independent of genetic influences for Helicobacter pylori infection? Arch Intern Med. 2000;160:105-9. [PMID: 10632311] Google Scholar10. Boonpongmanee S, Fleischer DE, Pezzullo JC, et al. The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated. Gastrointest Endosc. 2004;59:788-94. [PMID: 15173790] Google Scholar11. Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G. An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium. Gastrointest Endosc. 2008;67:422-9. [PMID: 18206878] Google Scholar12. Longstreth GF. Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol. 1995;90:206-10. [PMID: 7847286] Google Scholar13. Cook DJ, Fuller HD, Guyatt GH, et al. Risk factors for gastrointestinal bleeding in critically ill patients. Canadian Critical Care Trials Group. N Engl J Med. 1994;330:377-81. [PMID: 8284001] Google Scholar14. Strate LL. Lower GI bleeding: epidemiology and diagnosis. Gastroenterol Clin North Am. 2005;34:643-64. [PMID: 16303575] Google Scholar15. Rondonotti E, Marmo R, Petracchini M, de Franchis R, Pennazio M. The American Society for Gastrointestinal Endoscopy (ASGE) diagnostic algorithm for obscure gastrointestinal bleeding: eight burning questions from everyday clinical practice. Dig Liver Dis. 2013;45:179-85. [PMID: 22921043] Google Scholar16. Pennazio M. Techniques in Gastrotintestinal Endoscopy. 2012;14:94-99. Google Scholar17. Alain BB, Wang YJ. Cushing's ulcer in traumatic brain injury. Chin J Traumatol. 2008;11:114-9. [PMID: 18377716] Google Scholar18. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W; Practice Guidelines Committee of the American Association for the Study of Liver Diseases. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46:922-38. [PMID: 17879356] Google Scholar19. McGuire HH Jr. Bleeding colonic diverticula. A reappraisal of natural history and management. Ann Surg. 1994;220:653-6. [PMID: 7979613] Google Scholar20. Okazaki H, Fujiwara Y, Sugimori S, et al. Prevalence of mid-gastrointestinal bleeding in patients with acute overt gastrointestinal bleeding: multi-center experience with 1,044 consecutive patients. J Gastroenterol. 2009;44:550-5. [PMID: 19360374] Google Scholar21. Zuckerman GR, Prakash C. Acute lower intestinal bleeding. Part II: etiology, therapy, and outcomes. Gastrointest Endosc. 1999;49:228-38. [PMID: 9925703] Google Scholar22. Barkun AN, Bardou M, Kuipers EJ, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2010;152:101-13. [PMID: 20083829] Google Scholar23. Rockall TA, Logan RF, Devlin HB, Northfield TC. Selection of patients for early discharge or outpatient care after acute upper gastrointestinal haemorrhage. National Audit of Acute Upper Gastrointestinal Haemorrhage. Lancet. 1996;347:1138-40. [PMID: 8609747] Google Scholar24. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-21. [PMID: 11073021] Google Scholar25. Saltzman JR, Tabak YP, Hyett BH, et al. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc. 2011;74:1215-24. [PMID: 21907980] Google Scholar26. Strate LL, Orav EJ, Syngal S. Early predictors of severity in acute lower intestinal tract bleeding. Arch Intern Med. 2003;163:838-43. [PMID: 12695275] Google Scholar27. Strate LL, Saltzman JR, Ookubo R, Mutinga ML, Syngal S. Validation of a clinical prediction rule for severe acute lower intestinal bleeding. Am J Gastroenterol. 2005;100:1821-7. [PMID: 16086720] Google Scholar28. Das A, Wong RC. Prediction of outcome of acute GI hemorrhage: a review of risk scores and predictive models. Gastrointest Endosc. 2004;60:85-93. [PMID: 15229431] Google Scholar29. Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007;25:774-9. [PMID: 17870480] Google Scholar30. Hwang JH, Fisher DA, Ben-Menachem T, et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc. 2012;75:1132-8. [PMID: 22624808] Google Scholar31. Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007;22:1404-8. [PMID: 17716345] Google Scholar32. Srirajaskanthan R, Conn R, Bulwer C, Irving P. The Glasgow Blatchford scoring system enables accurate risk stratification of patients with upper gastrointestinal haemorrhage. Int J Clin Pract. 2010;64:868-74. [PMID: 20337750] Google Scholar33. Stanley AJ. Update on risk scoring systems for patients with upper gastrointestinal haemorrhage [Editorial]. World J Gastroenterol. 2012;18:2739-44. [PMID: 22719181] Google Scholar34. Stanley AJ, Ashley D, Dalton HR, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373:42-7. [PMID: 19091393] Google Scholar35. Cappell MS, Friedel D. Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin North Am. 2008;92:491-509. [PMID: 18387374] Google Scholar36. Zuccaro G Jr. Management of the adult patient with acute lower gastrointestinal bleeding. American College of Gastroenterology. Practice Parameters Committee. Am J Gastroenterol. 1998;93:1202-8. [PMID: 9707037] Google Scholar37. Huang ES, Karsan S, Kanwal F, et al. Impact of nasogastric lavage on outcomes in acute GI bleeding. Gastrointest Endosc. 2011;74:971-80. [PMID: 21737077] Google Scholar38. Barkun A, Bardou M, Marshall JK; Nonvariceal Upper GI Bleeding Consensus Conference Group. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843-57. [PMID: 14623622] Google Scholar39. Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol. 2012;107:345-60; quiz 361. [PMID: 22310222] Google Scholar40. Lin HJ, Wang K, Perng CL, et al. Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study. J Clin Gastroenterol. 1996;22:267-71. [PMID: 8771420] Google Scholar41. Sarin N, Monga N, Adams PC. Time to endoscopy and outcomes in upper gastrointestinal bleeding. Can J Gastroenterol. 2009;23:489-93. [PMID: 19623332] Google Scholar42. Tai CM, Huang SP, Wang HP, et al. High-risk ED patients with nonvariceal upper gastrointestinal hemorrhage undergoing emergency or urgent endoscopy: a retrospective analysis. Am J Emerg Med. 2007;25:273-8. [PMID: 17349900] Google Scholar43. Targownik LE, Murthy S, Keyvani L, Leeson S. The role of rapid endoscopy for high-risk patients with acute nonvariceal upper gastrointestinal bleeding. Can J Gastroenterol. 2007;21:425-9. [PMID: 17637943] Google Scholar44. Hearnshaw SA, Logan RF, Lowe D, et al. Use of endoscopy for management of acute upper gastrointestinal bleeding in the UK: results of a nationwide audit. Gut. 2010;59:1022-9. [PMID: 20357318] Google Scholar45. Lim CH, Ahmed MM. The optimal timing for urgent endoscopy in nonvariceal upper gastrointestinal bleeding [Letter]. Endoscopy. 2011;43:1018. [PMID: 22057771] Google Scholar46. Barkun AN, Bardou M, Martel M, Gralnek IM, Sung JJ. Prokinetics in acute upper GI bleeding: a meta-analysis. Gastrointest Endosc. 2010;72:1138-45. [PMID: 20970794] Google Scholar47. Pasha SF. Diagnostic yield of deep enteroscopy techniques for small-bowel bleeding and tumors. Tech Gastro Endosc. 2012;14:100-105. Google Scholar48. Baradarian R, Ramdhaney S, Chapalamadugu R, et al. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality. Am J Gastroenterol. 2004;99:619-22. [PMID: 15089891] Google Scholar49. Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013;368:11-21. [PMID: 23281973] Google Scholar50. Wolf AT, Wasan SK, Saltzman JR. Impact of anticoagulation on rebleeding following endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage. Am J Gastroenterol. 2007;102:290-6. [PMID: 17100959] Google Scholar51. Shingina A, Barkun AN, Razzaghi A, Martel M, Bardou M, Gralnek I; RUGBE Investigators. Systematic review: the presenting international normalised ratio (INR) as a predictor of outcome in patients with upper nonvariceal gastrointestinal bleeding. Aliment Pharmacol Ther. 2011;33:1010-8. [PMID: 21385193] Google Scholar52. Razzaghi A, Barkun AN. Platelet transfusion threshold in patients with upper gastrointestinal bleeding: a systematic review. J Clin Gastroenterol. 2012;46:482-6. [PMID: 22688143] Google Scholar53. Barkun AN, Martel M, Toubouti Y, Rahme E, Bardou M. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc. 2009;69:786-99. [PMID: 19152905] Google Scholar54. Laine L, McQuaid KR. Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials. Clin Gastroenterol Hepatol. 2009;7:33-47. [PMID: 18986845] Google Scholar55. Lau JY, Leung WK, Wu JC, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med. 2007;356:1631-40. [PMID: 17442905] Google Scholar56. Sreedharan A, Martin J, Leontiadis GI, et al. Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database Syst Rev. 2010:CD005415. [PMID: 20614440] Google Scholar57. Barkun AN. Should every patient with suspected upper GI bleeding receive a proton pump inhibitor while awaiting endoscopy? [Editorial]. Gastrointest Endosc. 2008;67:1064-6. [PMID: 18513549] Google Scholar58. Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med. 2008;359:928-37. [PMID: 18753649] Google Scholar59. Leontiadis GI, Sharma VK, Howden CW. Proton pump inhibitor therapy for peptic ulcer bleeding: Cochrane collaboration meta-analysis of randomized controlled trials. Mayo Clin Proc. 2007;82:286-96. [PMID: 17352364] Google Scholar60. Sung JJ, Barkun A, Kuipers EJ, Mössner J, et al. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2009;150:455-64. [PMID: 19221370] Google Scholar61. Lau JY, Chung SC, Leung JW, et al. The evolution of stigmata of hemorrhage in bleeding peptic ulcers: a sequential endoscopic study. Endoscopy. 1998;30:513-8. [PMID: 9746158] Google Scholar62. Bari K, Garcia-Tsao G. Treatment of portal hypertension. World J Gastroenterol. 2012;18:1166-75. [PMID: 22468079] Google Scholar63. de Franchis R; Baveno V Faculty. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J Hepatol. 2010;53:762-8. [PMID: 20638742] Google Scholar64. Fernóndez J, Ruiz del Arbol L, G—mez C, et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006;131:1049-56; quiz 1285. [PMID: 17030175] Google Scholar65. Laine L, Cook D. Endoscopic ligation compared with sclerotherapy for treatment of esophageal variceal bleeding. A meta-analysis. Ann Intern Med. 1995;123:280-7. [PMID: 7611595] Google Scholar66. Jensen DM, Machicado GA, Jutabha R, Kovacs TO. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med. 2000;342:78-82. [PMID: 10631275] Google Scholar67. Stollman N, Raskin JB. Diverticular disease of the colon. Lancet. 2004;363:631-9. [PMID: 14987890] Google Scholar68. Banerjee S, Cash BD, Dominitz JA, et al. The role of endoscopy in the management of patients with peptic ulcer disease. Gastrointest Endosc. 2010;71:663-8. [PMID: 20363407] Google Scholar69. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection—the Maastricht IV/ Florence Consensus Report. Gut. 2012;61:646-64. [PMID: 22491499] Google Scholar70. Kanwal F, Barkun A, Gralnek IM, et al. Measuring quality of care in patients with nonvariceal upper gastrointestinal hemorrhage: development of an explicit quality indicator set. Am J Gastroenterol. 2010;105:1710-8. [PMID: 20686458] Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAcute Gastrointestinal Bleeding Meeta Prasad Kerlin and Jeffrey L. Tokar Acute Gastrointestinal Bleeding Joseph D. Feuerstein and Daniel A. Leffler Metrics Cited byAcute Gastrointestinal BleedingJoseph D. Feuerstein, MD and Daniel A. Leffler, MD, MS August 6, 2013Volume 159, Issue 3Page: ITC2-1KeywordsAngiographyAnticoagulantsBloodBlood transfusionCoagulopathyColonoscopyEndoscopyGastrointestinal tractHemorrhageLesionsLigation assayMedical risk factorsNSAIDsOutpatientsPeptic ulcersResuscitationSigns and symptomsSmall intestineSurgeryUlcers ePublished: 6 August 2013 Issue Published: August 6, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

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