Upper Gastrointestinal Bleeding (UGIB) Questions & Answers

Updated: Aug 12, 2019
  • Author: Bennie Ray Upchurch, III, MD, FACP, AGAF, FACG, FASGE; Chief Editor: BS Anand, MD  more...
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Questions & Answers

Overview

What are the signs and symptoms of upper gastrointestinal bleeding (UGIB)?

How is upper gastrointestinal bleeding (UGIB) defined?

Which tests are performed in the workup of upper gastrointestinal bleeding (UGIB)?

When is CT scanning and ultrasonography indicated for the workup of upper gastrointestinal bleeding (UGIB)?

Which interventions are used in the treatment of upper gastrointestinal bleeding (UGIB)?

When is surgery indicated for the treatment of upper gastrointestinal bleeding (UGIB)?

What is upper gastrointestinal bleeding (UGIB)?

What is the role of peptic ulcer disease in the etiology of upper gastrointestinal bleeding (UGIB)?

What is the risk of recurrent upper gastrointestinal bleeding (UGIB) in peptic ulcer disease?

What are the major causes of upper gastrointestinal bleeding (UGIB)?

What is the pathogenesis of ulcer-related upper gastrointestinal bleeding (UGIB)?

How does vomiting cause upper gastrointestinal bleeding (UGIB)?

What is the role of Mallory-Weiss tears in the etiology of upper gastrointestinal bleeding (UGIB)?

What is the role of cute stress-related mucosal disease (stress ulcers) in the etiology of upper gastrointestinal bleeding (UGIB)?

What is the role of Dieulafoy lesions in the etiology of upper gastrointestinal bleeding (UGIB)?

What is the role of NSAIDS in the etiology of upper gastrointestinal bleeding (UGIB)?

What is the prevalence of upper gastrointestinal bleeding (UGIB)?

What are the sexual predilections of upper gastrointestinal bleeding (UGIB)?

What is the mortality and morbidity associated with upper gastrointestinal bleeding (UGIB)?

What is the prognosis for upper gastrointestinal bleeding (UGIB)?

Presentation

Which clinical history findings are characteristic of upper gastrointestinal bleeding (UGIB)?

Which physical findings are characteristic of upper gastrointestinal bleeding (UGIB)?

DDX

How is upper gastrointestinal bleeding (UGIB) categorized?

Which conditions are included in the differential diagnoses of upper gastrointestinal bleeding (UGIB)?

What are the differential diagnoses for Upper Gastrointestinal Bleeding (UGIB)?

Workup

How is upper gastrointestinal bleeding (UGIB) assessed?

How is hemorrhagic shock assessed in patients with upper gastrointestinal bleeding (UGIB)?

What is the role of transfusion in the initial assessment of upper gastrointestinal bleeding (UGIB)?

What is the role of a BMP in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of a coagulation profile in the workup of upper gastrointestinal bleeding (UGIB)?

Which to risk-stratifying tools are used in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of endoscopy in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of capsule endoscopy (CE) in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of chest radiography in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of CT scanning in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of CTA in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of nuclear medicine scanning in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of angiography in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of MDCTA in the workup of upper gastrointestinal bleeding (UGIB)?

What is the role of nasogastric lavage in the workup of upper GI bleeding (UGIB)?

Which nasogastric lavage findings suggest upper GI bleeding (UGIB)?

What is the prognostic value of nasogastric lavage findings in upper GI bleeding (UGIB)?

How is nasogastric lavage visualization improved for the assessment of upper GI bleeding (UGIB)?

Which histologic findings are characteristic of upper GI bleeding (UGIB)?

Treatment

What is the initial treatment for upper GI bleeding (UGIB)?

What is the role of surgery in the treatment of upper GI bleeding (UGIB)?

What are contraindications to surgery for upper gastrointestinal bleeding (UGIB)?

What is the role of proton-pump inhibitors (PPIs) in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the efficacy of proton-pump inhibitors (PPIs) in preventing upper gastrointestinal bleeding (UGIB) in patients taking antiplatelet or anticoagulant therapy?

What is the role of endoscopy in the treatment of upper gastrointestinal bleeding (UGIB)?

When is urgent endoscopy indicated for the treatment of upper gastrointestinal bleeding (UGIB)?

What is the efficacy of early endoscopy treatment of upper gastrointestinal bleeding (UGIB)?

Which endoscopic techniques are used in the treatment of upper gastrointestinal bleeding (UGIB)?

What is heater probe coagulation for upper gastrointestinal bleeding (UGIB)?

What is bipolar electrocoagulation for upper gastrointestinal bleeding (UGIB)?

What is the role of injection therapy in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of laser therapy in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of hemostatic clips in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of endoclips in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of argon plasma coagulation (APC) in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of hemostatic powders in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the role of Doppler ultrasonographic probes in the treatment of upper gastrointestinal bleeding (UGIB)?

How is a specific endoscopic treatment selected for upper gastrointestinal bleeding (UGIB)?

How are ulcers with an overlying blood clot treated?

How is active upper gastrointestinal bleeding (UGIB) and rebleeding treated?

What is the role of second-look endoscopy in the treatment of upper gastrointestinal bleeding (UGIB)?

What is included in post-endoscopic monitoring of upper gastrointestinal bleeding (UGIB)?

How is peptic ulcer-related upper gastrointestinal bleeding (UGIB) treated?

When is surgery indicated for the treatment of peptic ulcer-related upper gastrointestinal bleeding (UGIB)?

How is gastric ulcer-related upper gastrointestinal bleeding (UGIB) treated?

How are gastric ulcers classified?

What is the role of surgery in the treatment of gastric ulcer-related upper gastrointestinal bleeding (UGIB)?

How is stress ulcer-related upper gastrointestinal bleeding (UGIB) treated?

What is the role of surgery in the treatment of stress ulcer-related upper gastrointestinal bleeding (UGIB)?

How is upper gastrointestinal bleeding (UGIB) caused by Mallory-Weiss syndrome treated?

How is upper gastrointestinal bleeding (UGIB) caused by Dieulafoy lesions treated?

How is upper gastrointestinal bleeding (UGIB) caused by angiodysplasia treated?

How is upper gastrointestinal bleeding (UGIB) caused by aortoenteric fistula treated?

What are the possible complications of upper gastrointestinal bleeding (UGIB) treatment?

What is included in the long-term monitoring of upper gastrointestinal bleeding (UGIB)?

How is upper gastrointestinal bleeding (UGIB) prevented?

Medications

What is the role of medications in the treatment of upper gastrointestinal bleeding (UGIB)?

What is the efficacy of PPIs in the treatment of upper gastrointestinal bleeding (UGIB)?

How is H pylori eradicated?

What is the role of prokinetics in the treatment of upper gastrointestinal bleeding (UGIB)?

How should aspirin, NSAIDS and anti-thrombotics be managed in the presence of upper gastrointestinal bleeding (UGIB)?

What is the role of iron supplements in the treatment of upper gastrointestinal bleeding (UGIB)?

Which medications in the drug class Antibiotics are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class Iron Products are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class Histamine H2 Antagonists are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class Non-steroidal Anti-inflammatory Drug are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class H pylori Agents are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class Prokinetic Agents are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?

Which medications in the drug class Proton Pump Inhibitors are used in the treatment of Upper Gastrointestinal Bleeding (UGIB)?