ASGE Annual Postgraduate Course Endoscopy 2022: Breakthrough to Excellence | DDW 2022-Controlling GI Bleeding

Video Transcription

Video Summary

In this video, Dr. Jennifer Christie discusses the management of gastrointestinal bleeding based on guidelines from various sources. She highlights the importance of risk stratification and stabilization of patients. For upper GI bleeding, she recommends using the Glasgow-Blatchford scale for risk stratification, while the Oakland score is used for lower GI bleeding. Dr. Christie emphasizes the use of a restrictive transfusion approach to maintain hemoglobin levels between seven and eight. She discusses the timing of endoscopy, stating that urgent upper endoscopy within six hours may not be necessary, as there is no significant difference in mortality compared to endoscopy within 24 hours. Colonoscopy is recommended for lower GI bleeding and can be performed within 24 hours without significant differences in outcomes. Dr. Christie discusses various endoscopic therapies, such as bipolar coagulation, sclerosant injections, through-the-scope clips, and monopolar electrocoagulation. She mentions the use of new hemostatic techniques like hemospray and over-the-scope clips for ongoing or recurrent bleeding. The use of proton pump inhibitors (PPIs) post-endoscopy is recommended, but the timing and administration method may vary. If patients continue to bleed after intervention, repeat endoscopy is recommended, and the decision for further interventions like interventional radiology (IR) or surgery should be based on individual patient characteristics.

Asset Subtitle

Jennifer A. Christie, MD, FASGE

Keywords

gastrointestinal bleeding

risk stratification

restrictive transfusion approach

endoscopy timing

colonoscopy